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and  Foreign 2Medical Review.
RUECKERT, TH. J., A TREATISE  ON  HEADACHES; with Introduction,
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by JOHN C. PETERS, M.D., 1853. Bound. 75 cts.
" Dr. Peters' book owes its existence to the work of Dr. Riickert just alluded to, but it is
no mere translation, indeed it may almost be considered as an original and independent
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more than eighty additional cases taken from sources not accessible to Reickert, to wit, the
French, English and American homoeopathic publications. Scattered throughout the work
are many useful practical remnarks in the form of notes, and at the end is a good synopsis,
of the indications for the employment of the different remedies for headache. There is
also an excellent introductory chapter on the nature and causes of headaches, which contains much curious and interesting information.  We may give the reader some notion of
the immense amount of original matter in Dr. Peters' volume, when we state that the
number of pages in Rilckert's work occupied by headaches is but 68, whereas Dr. Peter's
book contains 173 pages of nearly equal size.
" Dr. Peters promises a second volume, on Apoplexy, Encephalitis, and HIydrocephalus,
still founded, we presume, on the work of Riickert; and if he shall follow Riickert
through all his diseases in the manner in which this volume is executed, we shall be forced
to admit that the German original has, like a bishop, gained by translation."-British
Journal of Homeopathy.
RUECKERT  ON  APOPLEXY  AND  PALSY.   Successful Homceopathic
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1853.  Bound.  75 cts.
This is another of the series of able monographs, for which the medical profession is indebted to the learning and zeal of Dr. Peters. It is founded on lRUECKERT'S Clinical Experience, but contains such large and important additions as to make it essentially a new
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Apoplexy is but 18, while Dr. Peters' book contains 164 pages of equal size. The editor
or rather author has availed himself freely of the labors of ROKYTANSKY, HASSE, SIMON,
LEHMANN and other foreign medical writers of distinction, as well as his own experience
in fifteen years study of Homoeopathy. He is not, however. to be regarded as a professional
sectarian. In the treatment of such terrible diseases as Apoplexy, Palsy and Softening of
the Brain, he strenuously urges the importance of discarding all considerations of prejudice, theory or system, and of aiming only at the welfare of the afflicted patient. The
Appendix on Softening of the Brain is peculiarly valuable, although the numerous and novel
remarks upon the action of many medicines, should not be overlooked.-M/ledical Neuws.
DISORDERS  OF  MENSTRUATION.-By JOHN  C. PETERS, M.D.   1853.
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This work, which is the first part of a Treatise on " Diseases of Females," by Dr. Peters,
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in a great measure, the object which the author seems to have had in view, viz.: to acquaint us, with all at present known, relative to the functions of menstruation, and the




Win. Radde, Publisher, 322 Broadway, New-York.
diseases consequent upon its derangement and irregularity. We may say that we concur
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work before us as one of the best, if not the very best, on the subject of which it treats.
As a compilation, we cannot too highly commend it. The opinions of the various writers
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with. The style is easy and flowing, and yet clear and pointed withal, which, in a work
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favored our readers, with a few extracts; but, as from what we have said, the majority
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We look forward with pleasure to the next part of this publication.-British and Foreign Journal of Homceopathy.
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but with the simplicity and directness that are essential to the perfect understanding of it.
This work is compiled and arranged upon the same plan as the Treatise on Disorders
of Menstruation and contains the highest medical authorities upon the subject in question.
The various diseases and derangements are considered in a way that will prove acceptable
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The work will be found a useful one; it is a compilation from the best authorities, and those
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page, and considered as an evidence of scholarship in his profession, the book is highly creditable to him and to the medical literature of the country. —Medical Nesws.
Just Published.
RUECKERT ON INFLAMMATORY AND ORGANIC DISEASES OF
THE BRAIN, by JOHN C. PETERS, M.D. Bound. 75 cents.
A COMPLETE TREATISE ON DISEASES OF THE HEAD, including
Headaches, Apoplexy, Vertigo, Palsy, Softening, Congestion, Irritation, Inflammation, Dropsy, Tubercular, Hydatids and  Cancerous Diseases of the
Brain, and Mental Derangement.  By JOHN C. PETERS, M.D.  Bound $3.
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A TREATISE ON DISEASES OF THE EYES. VOL. II.
Preparing for Press.
A TREATISE ON DISEASES OF THE EARS, THROAT AND NOSE.
DISEASES OF FEMALES. VOL. III. Or a Treatise on the Diseases of
the Womb, Ovaries, &c.




A
TREATISE
ON THE
INFLAMMATORY AND ORGANIC
DISEASES OF THE BRAIN.
INCLUDING:
IRRITATION, CONGESTION AND INFLAMMATION OF THE BRAIN, AND ITS
MEMBRANES, TUBERCULOUS-MENINGITIS, HYDROCEPHALOID DISEASE, HYDROCEPHALUS, ATROPHY AND HYPERTROPHY,
HYDATIDS, AND CANCER OF THE BRAIN.
BASED UPON
TH. J. RUECKERT'S "CLINICAL EXPERIENCE IN HOMEOPATHY."
By JOHN C. PETERS, M.D.
lN E W - Y 0 R KE:
WILLIAM RADDE, No. 322 BROADWAY.
PHILADELPHIA: RADEMACHER & SHEEK.-BOSTON: OTIS CLAPP.
LONDON: J. EPPS, 112 GREAT RUSSELL-ST., BLOOMSBURY.
MANCHESTER: TURNER, 41 PICCADILLY.
1 855.




Entered according to Act of Congress, in the year 1855, by
WILLIAM RADDE,
In the Clerk's Office of the District Court of the United States for the Southern
District of New-York.
HENRY LUDWIG,
Book & Job Printer, 45 Vesey-st.




ON THE
NATURE AND CAUSES
OF
IRRITATION, CONGESTION, INFLAMMATION, AND
DROPSY OF THE BRAIN, AND ITS MEMBRANES.
I.-I RRITATION  OF  THE  BRAIN.
IN CHILDREN.
DR. W. NICIOLL has thus designated a state of brain occurring in children, which appears to hold an intermediate
place between hydrocephaloid disease and that of inflammation.
It may on the one hand run into-inflammation if neglected; and
on the other hand is apt, if treated too actively and allopathically, to be followed by symptoms of exhaustion, and of the
ilydrocephaloid disease of Gooch and Hall.
In simple irritation of the brain the child is'wakeful, scarcely
ever sleeping, irritable, highly sensitive to every object of sight
and sound; the pupil is in many instances more or less contracted, the limbs are in action, the head tossed about; the
child cries without any apparent cause; there is unusual liveliness and animation; it wakes suddenly from sleep, and starts
at the least noise when awake; the fists are generally clenched.
with the thumbs turned in, and the forearms bent upwards on
the arms; and sometimes a degree of opisthotonos is observed,
the legs being drawn up, while the head is thrown back. This
state of things is usually, though not always, accompanied by
increased temperature of the head and of the skin generally,
and by an accelerated pulse.
A




2               IRRITATION OF THE BRAIN.
Some children seem to be much more prone than others to
this affection, and it is in the nervous, weakly and scrofulous
that it is most frequently seen. There is apparently an original difference or excitability of the nervous constitution, which
predisposes them to be thrown into this state of Erethism; and
when this natural predisposition is not present, defective nourishment, and a debilitated state of the system are apt to induce
it.  Any long continued irritation of the nervous extremities,
particularly of those distributed upon the mucous membranes,
may be the exciting cause of this affection; hence, painful dentition, worms, an unhealthy state of the stomach, bowels or
liver, or chronic and troublesome eruptions, or sores, or some
disease or impurity of the blood, may prove the exciting cause
of irritation of the brain or nervous system. When this state
obtains, convulsions, it is well known, are apt to occur.
The most deceptive part of the disease is, that the preternatural excitement and mobility of the nervous system is apt to
give rise to excitement of the heart and arteries, and determination of blood to the head, from  the excited condition of the
brain. If the case be regarded as one of active congestion or
commencing inflammation of the brain, and treated allopathically and antiphlogistically, irrespective of the peculiar state of
the nervous system, exhaustion will speedily follow, and the
symptoms of reaction and excitement from loss of blood will be
added; if the same treatment be still pursued, the case will
soon end fatally, and probably be attended with effusion of
water into the ventricles of the brain. If the body be examined
after death, the effusion will of course be detected, and will be
presumed to have been the cause of death; but the real truth
is, in certain states of the nervous system, unpreceded by any
great cause of exhaustion, an increased quantity of blood may
be thrown to the brain, and give rise to all the symptoms of the
first stage of an inflammatory affection, but which cannot be
removed by the ordinary allopathic antiphlogistic means, as
these will aggravate the original excited condition of the brain
and nervous system, inducing new and still more dangerous
symptoms, causing the case to terminate fatally, with all the
signs of an advanced stage of dropsy of the brain.
In older patients these cases are apt to be attended with




IRRITATION OF THE BRAIN.                 3
much delirium; WATSON Says they seem to be, but are not,
cases of Meningitis of any kind. ABERCROMBIE refers to them
as instances of a very dangerous modification of inflammation
of the brain, which shows only increased vascularity, without
any of the other signs or effects of inflammation. WATSON
very decidedly asserts that he entertains no doubt whatever,
about the nature of these cases, viz.: that they are not examples of inflammation at all, for they neither show the anatomical
characters of inflammation, nor do they yield to the remedies
for inflammation. In short, they were made to terminate fatally
by Abercrombie's outrageous system  of extravagant bloodletting. Apoplexy according to Abercrombie, may also arise
from exhaustion, and terminate fatally, when treated actively
by blood-letting, &c., without any morbid appearance being
found in the brain after death, or with appearances so slight as
to be altogether inadequate to account for the symptoms, or
fatal termination of the case.  (See treatise on Apoplexy.)
ABERCROMBIE himself admits that in four fatal cases of
Apoplexy, all the usual allopathic remedies were used in the
most active manner without the least effect in alleviating any
of the symptoms, and on inspection after death, either no vestige of disease could be discovered in the brain, or at most there
was but slight fulness of the blood-vessels, insufficient to account for death, which was doubtless caused by the too active
treatment.
Treatment.-NICHoLLS says that judicious treatment will
throw muchl ight on the pathology of these cases. If there be
any manifest cause of irritation present, either from teething,
or a disordered state of the bowels or liver, and this be removed
and the child then placed in as quiescent a state as possible, by
excluding it from light and noise, and every source of excitement, giving a dose or two of some sedative, and nourishing but
unstimulating diet, and subsequently a gentle tonic, all the
symptoms of brain disease will vanish.
The most homoeopathic remedies are: Coffea, Cannabis,
Thea, Ignatia, Nux. If these fail to afford relief; Conium,
Hlyosciamus, Opium, Asafoetida, Cham omilla or Valerian may
be tried.
COFFEA, THEA and CANNABIS may be used when the attack




4               CONGESTION OF THE BRAIN.
has been brought on by excessive and pleasurable excitement,
when the child is so excited and lively as to be almost uncontrollable, with sleeplessness, i. e. when the grey substance of the
brain, and the senses or intellectual faculties are principally
aroused, and stimulated.
Nux and IGNATIA are the principal remedies, when the
white substance of the brain, and the motor track and nerves
are implicated; when there is a tendency to twitching, starting,
&c., especially if the attack has been brought on by a fit of
passion, vexation or disappointment.
HYOSCIAMus and OPIuM are the antagonistic remedies for
COFFEA and THEA, and may be used when these remedies seem
indicated butfail to afford relief.
CoNIuM is the antagonistic remedy for Nux and Ignatia,
and may be given when these fail to afford relief.
II.-,CONGESTION  OF  THE  BRAIN.
IN CHILDREN.
ACCORDING to WEST, Congestion of the Brain is a very frequent disorder in young children; he quotes Dr. MAUTHNER
in proof, who on examining the bodies of 229 children, dead of
various diseases, found a congested state of the blood-vessels of
the brain, in no less than 186. WEST assUmes that the brain
in infancy is much more exposed to congestion and irritation,
than that of the adult, owing to the far wider variations of
which the cerebral circulation is susceptible in early life than
subsequently. Nor is the cause of this difficult to discover.
The skull of the adult is a complete bony case, and the firm
substance of the brain, affords a comparatively unyielding support to the blood-vessels by which it is nourished. The variations in the quantities of blood which the brain of the adult
contains, must needs be circumscribed within far narrower
limits than in the child, whose cranium, with its membranous
fontanelles and unossified sutures, oppose no such obstacle to
the admission of an increased quantity of blood, while the soft
brain keeps up a much slighter counterpressure on the bloodvessels than is exerted by the comparatively firm parenchyma




CONGESTION OF THE BRAIN.                 5
of the organ in the adult.  Hence, if the circulation in the
child be.disturbed, whether from difficulty in the return of
venous blood, as during a paroxysm of whooping cough, or from
increased arterial action, as at the onset of a fever, or during
the acute inflammation of some more or less distant organ, the
brain becomes congested, and delirium, or stupor, or convulsions
often announce the severity of the consequent disturbance of its
function. The same causes too, which expose the brain to be
over-filled with blood, render it possible for it to be drained
more completely of its blood, than in the adult. This fact
should always be borne in mind, when treating the diseases of
infants, for debility, exhausting discharges, and especially excessive allopathic depletion will often quickly induce a bloodless state of the brain, and all the symptoms of HIydrocephaloid
disease.
Hence, in the treatment of diseases of children, the physician
must be constantly on the watch against congestion of the
brain, as a condition which is very likely to come on, in the
course of the most various diseases, and of affections even of
quite distant organs. But it is not merely as a serious complication of many other diseases, that this congestion of the brain
in children deserves notice: its importance depends still more
on its constituting the first and curable stage of many diseases
of the brain, which, unless arrested at the outset, soon pass
beyond the resources of our art. —WEsT.
Congestion of the brain may arise from irritation; from the
presence in the blood of the poison of some eruptive disease,
such as scarlet fever, measles, or small-pox; or the brain may
become actively congested at the time of teething, or from feverish irritation of the whole system, or from exposure to the
sun, or from a blow upon the head, or from the fever of inflammation of some distant organ, such as the lungs, stomach, or
bowels, &c. Or a state of passive congestion may be induced
by some mechanical impediment to the return of blood from the
head, such as the general spasmodic compression of the bloodvessels such as occurs in general convulsions, or during a- fit of
whooping cough; or from the pressure of an overloaded stomach, or liver, or enlarged thymus or bronchial gland. Finally,
passive congestion, may be merely the result of a languid cir



6               CONGESTION OF THE BRAIN.
culation, arising from debility, or exhaustion, or want of pure
air, or of nourishing and sufficient food, such as occurs in diarrhcea or summer complaint, in which the child not only has a
great drain upon the system, but either is unable to take or
does not receive a sufficient of nourishing food, from a mistaken
policy on the part of the physician.
Intense congestion of the brain is not a very unusual consequence of the irritation of the brain and nervous system, from
the presence of the poison of some eruptive disease in the system, or from the acceleration and disturbance of the circulation
at the outset of the eruptive fevers. Convulsions and apoplectic symptoms then, sometimes, come on suddenly in a child,
previously to all appearances, in perfect health; and may even
terminate in death in less than twenty-four hours.  The brain
will be found loaded with blood, but all the other organs of the
body are quite healthy. We may be at a loss to account for
such sudden and severe symptoms unless measles, scarlet fever
or small-pox are prevailing, or some other child in the family
or neighborhood is soon after attacked by one or the other of
them. That this train of symptoms often arises from the presence of some morbid poison in the blood, is still more evident
from the occasional results of repelling eruptive diseases of the
scalp. Thus, GOLDING BIRD relieved a child of Porrigo with
external applications in three weeks; for a time it appeared
in perfect health, but in the act of crying "lPapa," it was attacked with a kind of spasm and dropped dead. Dr. DENDY
has seen four similar cases, in which death occurred as suddenly, all in the respectable classes.
When congestion of the brain and convulsions precede the
eruptive diseases, these symptoms as alarming as they generally
are, comparatively seldom end in death; for they generally disappear almost as if by magic, on the appearance of the eruption, except in those few cases in which the quantity of the poison is so
great, that it cannot all make its escape upon the surface; or
in which the congestion of the brain is kept up by the intensely
feverish state of the whole system.
The presence of some irritating substance in the blood, also
obtains in those cases in which convulsions, or irritation of the




CONGESTION OF THE BRAIN.                   7
brain arises from suppression of perspiration, scantiness of
urine, deficiency of bile or some other secretion.
Another cause may aid in keeping up or increasing the
pressure upon the brain in feverish disorders, viz.: an absolute
expansion or increase of the volume of the blood; the most
marked instance of this is in congestion of the brain from exposure to the heat of the sun, even though the head has not been
unprotected from its rays.  Of this WEST saw a striking instance in the case of a delicate boy, who when a year old, was
taken out by his nurse, during one of the hottest days of summer.  He was quite well and cheerful when he left the house,
but, after being out for some time, began to breathe hurriedly
and irregularly, and his nurse in consequence brought him
home.  He was restless, fretful and alarmed; his surface
generally hot, and his head especially so, the brain pulsating
forcibly through the anterior fontanelles; the pulse too rapid to
be counted; the respiration hurried, labored and irregular,
and there were constant startings of the tendons of the extremities.  The child was on the eve of convulsions, but the tepid
bath relieved the heat of the skin, and the expansion of the
blood, the pulse fell and the twitchings diminished. Light and
sound were excluded; he fell asleep and awoke in a few hours
refreshed and tranquillized, and on the next morning a little
languor was all that remained of an illness which seemed likely
to prove so formidable.-WEsT.  Cooling and soothing remedies are required in almost all cases of irritation, congestion, or
expansion of the blood.
Disorders of the nervous system are very frequent during the
period of teething.  Many of the symptoms which then occur,
are the direct result of irritation of the tri-facial nerve, but
others are the immediate consequence of congestion of the brain.
Febrile disturbance almost always attends upon the process of
dentition, and when the circulation is in a state of preternatural
excitement, a very slight cause may suffice to overturn its equilibriumn and occasion a greater flow of blood to the brain than
the organ is able to bear.  Suppression of perspiration, deficiency of bile and scantiness of urine, often occur during dentition and leave the blood overloaded with effete and irritating
substances.




8              CONGESTION OF THE BRAIN.
According to WEST, congestion of the brain may come on
very suddenly, its symptoms being alarming fron the first, and
such as to call for immediate interference; or general uneasiness, a disordered state of the bowels, which are generally,
although not invariably constipated, and feverishness may precede the more serious attack by a few days. The head becomes
hot by degrees, the child grows restless and fretful, and seems
distressed by light and noise, or sudden motion, while children
who are old enough sometimes complain of their head. Usually, too, vomiting occurs repeatedly, a symptom which is not only
confirmatory of others, but also may exist before there is any
well-marked indication of the head being affected, and when,
though the child seems ailing, there is nothing definite about its
illness. The degree of fever which attends this condition varies much, and its accessions are irregular; but the pulse is
usually much and permanently quickened; and, if the skull be
unossified, the anterior fontanelle (or soft spot on the top of the
head,) is either tense and prominent, or the brain is seen and
felt to beat forcibly through it. The sleep is disturbed, the
child often waking with a start, while there is occasional twitching of the muscles of the face, or tendons of the wrist. The
child may continue in this state for many days, and then recover its health, with or without medical interference; but, a
slight cause will generally suffice to bring back the former indisposition. Striking instances of this are often seen while
children are teething; the fever may subside, the head grow
cool, and the little patient appears quite well as soon as a tooth
has cut through the gum, but the approach of each other tooth
to the surface will be attended by a recurrence of the symptoms.
Yet, we cannot always reckon on such a favorable result occurring; for the symptoms above mentioned are sometimes the
indlications of the system generally having begun to suffer from
mischief which has been going on for months unnoticed, and
which is now about to break out with all the formidable characters of acute dropsy of the brain. Or, should they have no
such serious import, yet congestion of the brain is itself a serious and sometimes a fatal malady.  Even though on treatment being adopted, the heat of the head may diminish, and the
flush and heat of the face grow slighter and less constant, still




CONGESTION OF THE BRAIN.                 9
the countenance may become very heavy and anxious, the indifference to surrounding objects may increase, and the child finally lie in a state of torpor or drowsiness; from which, however,
it can at first be aroused to complete consciousness. But after
being aroused, it soon subsides into its former drowsiness; the
bowels generally continue constipated, and the vomiting seldom
ceases, though it is sometimes less frequent than before. The
pulse usually becomes smaller than in the first stage, and
though there is often irregularity in its frequency, no actual
intermission occurs. An attack of convulsions sometimes marks
the transition from the first to the second stage; or the child
passes without any apparent cause, from its previous torpor
into a state of convulsions, which subsiding, leaves the torpor
deeper than before. The fits may return and death take place
in one of them, or the torpor growing more profound after each
convulsive seizure the child at length dies comatose.
The second stage, if it may so be called, is usually of short
duration, and if relief be not afforded by appropriate treatment,
death is seldom delayed beyond forty-eight hours from the first
fit, though no graver lesion may be discovered afterwards than a
gorged state of the vessels of the brain and its membranes, and
perhaps a little clear fluid in the ventricles and below the
arachnoid.
Occasionally, death does not so speedily follow these symptoms; but they may continue slightly modified for days, or even
weeks, and contrary to all expectation, recovery now and then
takes place, especially in very young children, in whom the
congestion! having relieved itself by a copious effusion of water
into the ventricles of the brain, the yielding skull accommodates
itself to its increased contents. This chronic dropsy of the
brain may even admit of cure.
Treatnment.-The principal homoeopathic remedies are: Glonoine, Opium, China, Ferrum, Belladonna and Stramonium.
If these fail, their antagonistic remedies, Aconite, Digitalis
Conium or Veratrumn-viride may be used. (See Treatise on
Apoplexy.)




10        INFLAMMATION OF THE DURA MATER.
INFAMMATION OF THE MEMBRANES OF THE BRAIN.
I.-INFLAMMATION OF THE DURA MATER.
ACCORDING to ROKITANSKY, primary inflammations of the
dura mater to any extent, such, for instance, as would lead to
the formation of matter, are of rare occurrence, with the exception of those which are brought on by injury.
On the other hand, inflammations of slight degree, and usually combined with moderate inflammation of the bones of
the skull, are frequent.  They are characterized by vascularity and rosy-redness of the dura mater, and by softening
of its texture; they give rise to interstitial infiltrations of
the membrane with the products of inflammation, as well as to
exudations upon that surface of it which adjoins the bone; such
exudations become organized into loose cellular, or thick fibrous
tissues, or at length, especially if there be any attendant inflammation of the bone, into bone; and they bring about a preternatural adhesion to the inner surface of the skull.  These
patches of inflammation are often widely spread, especially
along the sutures; but sometimes they are confined within a
smaller compass, so as to form circumscribed islands. Exudations which become converted into bone are generally spread
out into a thin layer like that of puerperal osteophyte; they are
first spongy, but gradually become compact: sometimes they
form a mass of bone which looks as if it had flowed or dropped
upon the membrane, and then coagulated; while, not unfrequently there are circumscribed plates or nodules, which, though
they in course of time become intimately united to the bone,
yet originally adhered firmly to the dura mater.
When the inflammation is more intense, and runs a chronic
course, the dura mater acquires an increase in thickness, sometimes to the extent of three lines, and even more; it becomes
indurated and callous, and usually adheres more closely than
natural to the bone.
When the inflammation is brought on by injury, or extends
to the dura mater from the neighboring tissues, it frequently




INFLAMMATION OF THE DURA MATER.              11
terminates in the production of pus, and in suppurative degeneration of the membrane. These cases are of great importance,
for they are generally secondary to inflammation and suppuration of the bone, or of the neighboring ligamentous structures.
They are especially apt to occur in certain localities; thus, the
dura mater often inflames, suppurates and sloughs from caries
of the bones of the internal ear, and the labyrinth of the ethmoid bone of the nose; from caries of the upper bones of the
spine, and suppuration of their ligaments. In the dura mater
these processes remain limited and circumscribed, but when
they reach the inner membranes of the brain, they usually
spread rapidly into general meningitis.
iSymptoms.-Inflammation of the dura mater according to
WATSON rarely occurs as a spontaneous disease, but is not at
all uncommon as a result of external injury. Its symptoms
have been excellently well described by POTT: A man receives
a blow upon the head; the blow stuns him perhaps at the time,
but he presently recovers himself, and remains for a certain
period, apparently in perfect health.  But after some days he
begins to complain; he has pain in his head, is restless, cannot
sleep, has a frequent and hard pulse, a hot and dry skin, his
face becomes flushed, his eyes red and ferrety; chills, nausea
and vomiting supervene, and towards the end, convulsions and
delirium.  Meanwhile the part of the head which has been
struck becomes puffy, tumid and sometimes tender, and -if this
tumid part of the scalp be cut through, the pericranium beneath
is found separated from the skull; and the bone of the skull
itself is observed to be altered in color, whiter and drier than
the healthy bone; and if a piece of the bone be removed, it is
also seen that the dura mater, on the under side of it is detached from the skull, and sometimes smeared with lymph or
puriform matter.  This is a disease which is often met writh by
the surgeon.
According to SOUTH and CHELIUS inflammation of the dura
mater may be acute or chronic.
Acute inflammation of the dura mater appears most commonly from the third to the fifth day after the injury; the patient complains of severe oppressive headache, which spreads
from the injured part over the whole head; the heat of the




12        INFLAMMATION OF THE DURA MATER.
head is increased; the pulse is small, compressed and rather
hard; the patient is heavy and difficult to arouse; his ideas
become unconnected, and quiet delirium comes on; and lastly,
when the inflammation proceeds to suppuration, the patient falls
into a state of continued stupefaction, from which he cannot be
easily aroused; convulsions come on, with continued shivering
and irregular pulse; the pupils are wide and fixed; the breathing snoring and slow; the sphincters are paralyzed and finally
the patient dies.
On dissection, the dura mater is found reddened, covered
with exudations, and separated from the inside of the skull;
pus may be found between it and the skull, and at this part the
dura mater is often gangrenous.
Chronic inflamnation of the dura mater, from injury to the
head, often commences only after a long space of time, often
after seven or fourteen days, often after a month; it begins
with headache, mental and bodily depression, heaviness, unsteady walk, derangement of the stomach, quick pulse; and in
its further course a circumscribed painful swelling of the scalp
commonly arises at the place of injury; or, if there be a wound,
it becomes pale, and secretes a thin, sanious fluid, which sticks
fast to the bandages. The pericranium suppurates around the
wound, and the inflammation soon runs into exudation of a yellowish, ichorous, purulent fluid, which collects either between
the skull and the dura mater, or between the latter and the
surface of the brain. The patients sometimes die twelve or
eighteen months after the injury.  SOUTH has seen several
cases of this chronic inflammation, which is always a serious
disease, and very difficult to control; often indeed entirely unmanageable under allopathic treatment. The patient then goes
on slowly from bad to worse; sometimes with intervals of improvement, and sometimes without, and will frequently live for
many months in a constant state of suffering.
According to WATSON the next most frequent cause of inflainmation of the dura mater, after injuries of the head, is disease of the internal ear, and of the petrous portion of the
temporal bone.  Sometimes acute inflammation arises within
the tympanum, when there has been no previous disease of the
ear: the patient has severe earache; at length a gush of mat



INFLAMMATION OF THE DURA MATER.               13
ter comes from the external meatus, but the pain does not cease,
as it usually does in such cases; it continues, or even increases
in intensity; the patient begins to shiver, becomes dull and
drowsy; slight delirium perhaps occurs, and by degrees he
sinks into stupor. In some instances no pus issues externally.
More commonly symptoms of the same kind supervene upon a
chronic discharge of purulent matter from the ear, especially as
a sequel of scarlet fever. In some of these cases there is no
symptom  to mark the extensive mischief going on within the
head, except the intense pain; the pulse may not be quickened,
the skin may be warm but moist, and there may be neither fever, delirium or convulsions. In other cases, besides the intense
pain in the head, there may be vomiting, intolerance of light,
slight and transient delirium, a degree of stupor, and slight convulsions.
In some cases, pus is absorbed from the ear, and diffuse inflammation of the veins with terrible consequences in various
parts of the body may ensue. In such cases the complaint is
marked by pain in the head, fever and chills which intermit;
and so regular sometimes are the intermissions that the physician may be led to believe that he has fever and ague to deal
with; then pain and swelling of some of the joints may come
on, leading to the belief that the case is complicated with rheumatism; but the true and alarming nature of the case will soon
become apparent;  abscesses form  in and about the affected
joints, and if they be opened, foul, grumous and dark colored
matter will be let out. The patient will generally have more or
less fever, with dry parched tongue, rapid and feeble pulse, with
more or less diarrhoea.
In short, in these cases the patient has pain in the ear, with
discharge of pus from the external meatus, followed by pain in
the head coming on with fever and chills, and followed afer a
short interval by destructive suppuration in several distant
parts; all forming a chain of presumptive evidence that the
fatal mischief finds its entrance into the head and rest of the
system through the porches of the ear.
Although quotidian paroxysms of fever have been noticed in
several cases, still in one case at least the fever bore a tertian
type: A young man previously healthy was attacked with fits




14        INFLAMMATION OF THE DURA MATER.
of shivering, accompanied by pain on the left side of the head;
at first the paroxysms were rather irregular; but they soon
assumed the form of tertian ague, coming on every other day,
at about the same hour; the cold fit commencing at noon and
lasting about half an hour, followed by a hot fit of somewhat
longer duration, and terminating in profuse perspiration. In
the intermissions the pain in the head was trifling, there was no
thirst or fever, but the patient did not sleep. A tumor formed
over the mastoid process, and was opened, giving issue to a
quantity of extremely offensive brownish pus, followed by great
relief; but in about ten days the pain in the head and ear became very severe, with violent shivering fits many times a day,
great thirst, heat of skin, vomiting and delirium; his face was
flushed and pulse hard; he soon died.
Suppuration of the tympanum and consequent disease of the
bone, are more common in scrofulous persons than in others;
and they are more apt to occur as sequelse of scarlet fever, than
in any other way.
Treatment.-The remedies which act principally upon the
sero-fibrous tissues are most specific in this disease, viz.: Aconite, Bryonia, Mercurius, Mezereum, Colchicum, &c.
When it arises from a mechanical injury to the head, the
treatment may be commenced with Arnica, internally and externally; when fever arises, Aconite should be used internally,
and the Tincture of the Root should be applied freely and repeatedly to the external surface of the head, avoiding the cut
or woundecd surfaces; if the case progresses steadily, Mlercurius should be given in alternation with Aconite; if signs of
effusion of serum and fibrine from the inflamed membrane arise,
Bryonia, Mezereum, Hellebore or Colehicum, should be used in
alternation with Mercurius, or the Iodide of Mercury; if the
symptoms of purulent exudation arise, Tartar-emetic, or Heparsulph., Sabina or Thuya should be given.




INFLAMMATION OF THE ARACHNOID.                15
INFLAMMATION OF THE ARACHNOID.
ARACHNITIS.
THE arachnoid membrane is a shut sack, the parietal layer
of which is attachhed to the dura mater, while the cerebral or
visceral layer is folk the most part blended with the pia mater
of the brain.
Inflammations of the parietal layer of the arachnoid, are on
the whole of frequent occurrence; their pathological import,
however, is according to ROKITANSKY, mostly subordinate;
they are met with, from injuries of the skull, from what is
called a phlogistic state of the blood, in pynemmia, in the course
of acute eruptive diseases, in Bright's disease, and acute biliary
dyscrasia.  They are commonly slight in degree; the inner
surface of the dura mater is then found streaked with delicate
red vessels, and is of a clear rosy tint; it is lined with an exudation, that may be delicate or greyish, and soft like a layer of
mucus; or more consistent and membranous, or yellow, loose
and pus-like.
In some rarer cases, this inflammation of the parietal layer
has all the appearance of being primary, and judging  from the
amount of its products, also severe. These processes usually
take place, and furnish their products without being accompanied by any similar disease in the cerebral layer: even in the
intense primary inflammation, just alluded to, the change which
takes place in the cerebral layer is limited to cloudiness and
thickening; the false membrane very rarely produces any adhesion between the two surfaces.
Inflammation of the cerebral layer of the arachnoid presents
peculiar appearances, in respect to the condition of the pia
mater.  We find'on the one hand, that, as arachnitis is not
usually fatal in itself, or at least not in an early stage, it
sometimes leaves traces of its existence, in pretty extensive
thickenings of the membrane; in free exudations on its surface,
which become converted into circumscribed tendinous patches,
or diffused false membranes, &c., whilst very trifling changes
are discoverable in the pia nzater, to indicate that an inflam



16         INFLAMMATION OF THE ARACHNOID.
matory process occurred at the same time in it. When, on the
other hand, the pia mater is acutely inflamed, and there is
profuse exudation into its tissue, the subjacent arachnoid is in
no marked degree affected, and its surface is entirely without
any free exudation. Showing that the inflammations of the two
membranes are entirely diifftrent and distinct, and that specific
remedies nmust be found to act curatively upon each.
Purulent exudation on the free surface of the arachnoid takes
place on the parietal layer only when the dura mater is
very acutely inflamed in consequence of injury of the skull and
caries, proving that remedies which act specifically upon the
bones and dura mater, will also probably act specifically in inflammations of the parietal layer of the arachnoid; and on the
cerebral layer, only when a simultaneous acute inflammation of
the pia mater also gives rise to an exudation of pus; proving
that remedies which act specifically upon the pia mater, will
also probably act specifically upon the cerebral layer of the
arachnoid.
It is remarkable that true tubercular exudations do not occur
on the arachnoid; proving that remedies which act specifically
upon the arachnoid may prove antidotal to tubercular disease.
Finally, according to ROKITANSKY, on whichever layer of
the arachnoid these processes take place, that portion which corresponds to the convexity of the hemispheres of the brain is
exclusively affected; and in proportion as they approach the
base of the brain, (which they occasionally do), the intensity of
the inflammation, and the quantity of their products is palpably
diminished; again proving that remedies which act specifically
upon the upper surface of the brain, and upon the arachnoid
are antagonistic, or antidotal to tubercular disease, which acts
principally upon, the base of the brain, and upon the pia mater.
Symptoms and Treatmnent. —These are very similar to
those of simple inflammation of the pia mater, and cannot be
definitely given in the present state of our knowledge.




INFLAMMATION OF THE PIA MATER.                17
INFLAMMATION OF THE PIA MATER.
MENINGITIS.
TH IS is the truie meningitis, and the most important disease
of the membranes of the brain.  According to ROKITANSKY it
is impossible to depict its general features without,distinguishing two totally different forms of the disease.
a) Firstform.-This is a true inflammatory affection; it usually extends over the convexity of the brain, and diminishes in
intensity as it approaches the base. It rarely occurs at the base
of the brain at all.
The individuals who present this form  of disease are generally in the youthful period, the bloom of life; they are usually
strong, at any rate they show no trace of the tubercular dyscrasia.
The disease is usually unaccompanied with acute dropsy of
the brain; at least the exudations and effusions found in the
ventricles are mostly slight; so also, softening of the stomach
does not usually accompany or result from it.
Except at its periphery or convexity, the brain is unaltered
by it, especially no softening of the brain arises or results
from it.
It is a pure inflammatory affection and if any specific remedies against simple inflammation are known in any school of
medicine, it ought to be a perfectly manageable disease. In
fact ROKITANSKY says, although this form of meningitis is
frequently fatal, yet it often terminates in resolution. A chronic form of it is frequently found in mental disease, especially
in cases of secondary imbecility; yet it is frequently acute and
even epidemic.
b) Second form. —This is the most frequent and fatal disease of the membranes of the brain, especially in children.  It
occurs according to ROKRTANSIKY almost exclusively at the
base of the brain, and the peculiar opaline, flocculent, albuminoserous, gelatinous, sero-purulent effusions and exudations which
attend it, accumulate especially between the hemispheres of the
brain on each side, from the optic commissure in front to the
B




18         INFLAMMATION OF THE PIA MATER.
pons, and even over the medulla oblongata behind.  From
thence they may be traced into the fissure of Sylvius, and the
longitudinal fissure of the brain, and so on to the convex surface
of the hemispheres; for the fibrino-tuberculous product accumulates along the vascular trunks which run in the fissures,
viz.: the arteries and veins of the fissure of Sylvius and Corpus-callosum, and the latter often appear completely enveloped
in the exudation.
From  these points the inflammation always extends also to
the choroid plexuses and the lining membrane of the ventricles,
particularly the lateral ventricles, and there gives rise to the
effusion and exudation of similar products, from which a distinct
purulent sediment is often deposited; hence it is almost always
combined with acute dropsy of the brain; and very often it is
also associated with softening of the stomach.
The brain itself is always in a state of acute oedema, or serous infiltration, with hydrocephalic swelling. At those parts
where the disease is most intense, and particularly in the fissures of Sylvius, the convolutions of the brain, especially at the
superficial parts, become the seat of red, or yellow softening.
The subjects of this form of the disease are mostly children,
although it is also frequent at later periods of life. The individuals who are attacked with it are generally persons already
suffering with the tuberculous dyscrasia, or those in whom tubercle is actually deposited.
The base of the brain is the chief seat of this form of tuberculosis; from thence it extends towards and over the hemispheres; it is rare to find the convex surface of the brain the
principal seat of its development.-ROKITANSKY.
It is the most frequent and fatal disease of the head; as it is
generally associated with the deposit of tubercles in other, and
often many other organs, with extensive dropsy and softening
of the brain; and with decided softening of the stomach, there
is almost necessarily scarcely any chance of recovery.
Symptoms of primary meningitis.-This disease is most
frequent in persons from the age of sixteen to forty-five years;
next, in children from five and a half to eleven years; it is very
rare in infants, and more common in males than females. It is
most frequently caused by exposure to the sun, by excessive




INFLAMMATION OF TIHE PIA MATER.                19
intellectual labor, by intemperance in drinking, and by depressing mental emotions; in children it is most common during
dentition, or from suppression of eruptions of the scalp.
In the simple, primary form of the disease, the pain in the
head is always very prominent, and sets in at the very beginning of the attack; it is violent and continued, with more or less
severe exacerbations; it often obliges the patient to cry out; it
is complained of spontaneously and unceasingly; the patient
insists that his disease is solely in his head, can point to the
exact seat of it, and complains of it until he falls into a state of
unconsciousness.
The intelligefnce is very quickly involved in mlthe great majority of cases; there is great rental agitation, soon followed by
active delirium, which is sometimes violent, or even furious.
The patients are apt to get out of bed, and attlempt to jump
out of the window, &c. This is soon followed by somnolence,
which alternates at first with the delirium, but finally settles
into a profound coma, or complete loss of consciousness.
The eyes are sensitive to light, the pupils are almost always
dilated, but at times they are contracted or irregular; they
finally become immoveable, and in some cases vision is entirely
abolished; squinting is also frequentil observed, especially in
children.
The nerves of motion do not ordinarily present any peculiar
symptoms, especially in the early stages of the disease, except
that the patient is apt to totter and fall if he attempts to rise;
at a later stage, however, we often notice stiffness of the limbs,
or spasmodic contractions, or even convulsions; but these symptoms are not constant.  Towards the end of the attack, subsultus, carphologia, and convulsive rlovements are generally present.  It is rare that we observe partial stiffness of one limb, or
paralysis; when these are present, there generally is a simultaneous affection of the brain itself.
Sometimes the nerves of sensation are blunted, either throughout the whole body, or in more or less extensive parts; at times,
however, there is an increase of sensibility, at least for a time.
The countenance is generally animated, the eyes haggard and
brilliant;  there are frequent alterations of color, from red to
violet; and thence to pallor, more or less intense. Sometimes




20         INFLAMMATION OF THE PIA MATER.
the features are contracted and grimacing, at others they are
relaxed. The eyes often express astonishment, fright or fury;
at others they seem dull, glassy, and without expression; at
times they are prominent, at others sunken. An unintelligent
smile often flits over the features.  The nostrils are generally
dry; the lips pale and parched.
Of the symptoms oft the digestive organs, the vomitings are
without doubt the most remarkable; they are generally bilious,
and often abundant; they often cease on the second or third
day of the attack, but sometimes persist to the end, although
they may intermit for a time, to be renewed again.  The tongue
is generally dry, often red, or covered with various kinds of
coating.  Constipation is also one of the most constant symptoms; it generally sets in from the beginning, and may even
precede the other phenomena.
The breathing is generally. remarkably irregular.
Fever is always well marked, the pulse is quick and hard at
first; afterwards it becomes small and irregular.  The skin is
hot and remarkably dry.
Secondary mzeningitis occurs during the course of some
other disease, especially typhoid fever; the headache is apt
to be not very well marked; the vomitings are often absent;
the most remarkable symptoms are the softness, and irregularity of the pulse and respiration, the paleness and expression of
anxiety upon the face, and the extreme agitation which precedes
the deliriuim.
The course of the disease is onwards, and although there are
some exacerbations, yet the remissions are not as notable as in
tubercular meningitis.  The duration of the disease is very
short; it does not last longer than from three to nine or eleven
days.
Diagnosis.-Inflammnation of the pia mater may be mistaken
for tubercular meningitis, or for typhoid fever.  But in tubercular meningitis there are generally preceding signs of illhealth, or of tubercular disease; the symptoms of inflammation
of the pia mater set in more suddenly, are more severe from the
onset, and persist more actively; the headache is more violent,
also the heat of the head, redness of the face and intolerance of
light; the delirium  is also more intense; the vomitings are




INFLAMMATION OF THE PIA MATER.                 21
more frequent and abundant; the fever more severe and constant.  The symptoms progress more rapidly and regularly.
It may be distinguished from typhoid fever by the less frequent vomiting, more frequent pains in and distension of the
bowels, with diarrhoea, which are so characteristic of the latter
disease; enlargement of the spleen may also be distinguished
by percussion; bleeding from the nose and ringing in the ears,
the rose colored spots, sudamina, the regularity of the pulse and
breathing, and absence of rigidity or paralysis of the limbs will
also serve to distinguish the two diseases.
Treatment.-If the symptoms of arachnitis or meningitis
begin to show themselves, or even if the disease be fully developed we may begin the treatment with Aconite; it acts specifically upon the serous and fibrous membranes, and is thought
to be homceopathic to all acute inflammations, while physicians
of the dominant school suppose it to be as antipathic to all
acute inflamnmations and congestions as Digitalis or Veratrumviride.  According to KREUVSSLER it is not a question of fever
or no fever, for an acute inflammation of the brain as well as of
the meningeal membranes requires the use of Aconite, from the
commencement of the disease until the period when essential
changes develop the full characters of the affection.  lIe says
it is always safe to commence the treatment with a few doses of
Aconite, even if it be possible to discern the homceopathicity of
another and apparently more specific remedy from the very beginning of the attack.
]Doe0 —Of course, in so serious a disease, the remedy should be
used promptly and thoroughly; it should be given not only internally, but also applied externally, and that right freely. I have been in
the habit of applying the Tincture of the Root of Aconite, over a
large portion of the scalp, every 2, 4, 6 or 8 hours, according to the
severity of the symptoms. The Tincture of the Plant may be given
in repeated doses, every 1, ~A, 1 or 2 hours, in acute and rapid cases
every 2, 4 or 6 hours, in sub-acute and slighter attacks.*
If the case progress, so that it is probable that exudations of
plastic lymph or sero-fibrous effusions have already commenced
to take place, then Bryonia and Mercurius are the lmost important remedies; if there be much vomiting with obstinate
constipation, great heat of head and much fever, one or two full
* The dilutions and pellets are probably not useful in cases of meningitis of any kind.




22         INFLAMMATION OF THE PIA MATER.
doses of lMiercurius may be given so as to bring about free
action upon the bowels.  Small doses of Tartar-emetic may
also serve to allay the irritability of the stomach, to moderate
the fever, tend to produce perspiration and aid the action upon
the bowels; but they must not be continued long, or else too
great prostration may be produced.  The Tartar-emetic must
be quickly changed to alternate doses of Bryonia, and small but
repeated doses of Mercurius.  If Mercurius be at all indicated
it may also be allowable to apply a weak solution or ointment
upon the scalp, in the immediate neighborhood of the seat of the
disease.
If it becomes apparent that a large effusion of serum, has
taken place from the inflamed membranes, Helleborus, Digitalis, Kali-hydriodicum, and  Mercurius-iodatus, become the
principal remedies. If Hellebore and Digitalis, either singly
or in alternation fail to produce an alleviation of the symptoms,
Kali-hydriodicum may be applied over the whole of the scalp in
solution, or in the formn of an ointment, and frequently repeated
small doses may be given internally.  If these also fail, Iodide
of Mercury may be applied in the form of an ointment over the
scalp, and small doses of this, or of Mercurius-corrosivus may
be given internally.
If an almost entire suppression of urine occur, Cantharides
will prove the most homoeopathic remedy. It is far more homoeopathic to inflammations of the membranes of the brain than
either Belladonna, Stramonium or Hyosciamus, which only produce congestion, rarely inflammation of these parts.  Cantharides has caused congestion of the vessels of the brain; thickening of the arachnoid of the brain, but especially of the cerebellum, which is covered with a very thick layer of lymph, while
a large quantity of serum has been found at the base of the
brain. As the suppression of urine in arachnitis and meningitis, does not depend upon an inflammation of the kidneys, but
upon a torpid or semi-paralytic state of these organs fronm pressure upon the brain, Cantharides which acts far more specifically upon the kidneys, than upon the brain or its membranes,
may arouse the former organs from their torpor, and bring on a
secretion of urine which may relieve the pressure upon the
brain; at the same time it will not exert an injurious or too




INFLAMMATION OF THE PIA MATER.                 23
irritating effect upon the brain or its membranes, as the stage
in which it is most indicated, and hence is most useful, is that
in which the profuse exudation of fibrine and copious effusion of
serum  from the meninges of the brain has brought about a
resolution of the inflammatory congestion of these organs, and
left them  in a state of torpor from over-exertion and secretion,
which will not bear debilitating remedies, and may tolerate exciting or stimulating ones; the depressed state of the general
system when copious effusion has taken place, marked by sopor
with complete insensibility to external impressions, with a small
feeble and intermitting pulse, coldness and clamminess of the
skin, calls for the. use of stimulants, and Cantharides may prove
the best, from  its specific relation to the seat and nature of the
disease, and its marked power over the secretion of the kidneys,
which it is so important to restore.  If the case be not absolutely hopeless, and the internal use of Cantharides does not
produce the desired effect, and the physician and parents are
willing to inflict some suffering in the hope of saving life, which
might otherwise be lost, a blister of Cantharides may also be
applied to the back of the neck, or even to the scalp.  But such
an extreme and severe measure should only be used in cases of
pure or simple arachnitis, or meningitis; if it be at all probable
that tubercular neningitis be present, all temptations to severe
and active measures should be steadily rejected by the physician, whose sole endeavors in such almost invariably hopeless
cases, should be directed towards soothing and allaying any
and every painful symptom of the case; narcotic remedies, such
as Belladonna, Conium, Hyosciamus, Opium, or Stramonium, or
Cannabis-indica, or Chloroform should be used freely and without
hesitation.  To save life is next to impossible; to allay suffering is both possible and imperatively demanded.
It may be allowable to mention here that Dr. HAHN has sueceeded several times with the cold affusion, in arousing and
curing children, after the supervention of complete coma.  He
has also succeeded in 14 cases, after the patients were in an apparently hopeless state of coma, with frictions of the scalp, with
Tartar-emetic ointment repeated every two hours, until pustulation was established; it is a severe measure and occasionally
induces gangrene of the scalp, yet it is perhaps allowable in the
advanced stages of simple inflammatory meningitis.




24               TUBERCULAR MENINGITIS.
TUBERCULAR  MENINGITIS.
IN CHILDREN.
THis is one of the most common diseases of the brain or its
appendages in children.  It is by far the most common cause of
so-called acute- or sub-acute dropsy of the brain, and furnishes
a satisfactory reason why this disease is so frequently fatal
under every variety of treatment, at the same time that it renders it self-evident that any physician or class of physicians who
pretend to cure the majority of their cases of dropsy of the
brain, are either self-deceived, or are absolute impostors.
GREEN says that at least one-fourth of all the diseases of the
brain in children are tubercular in their nature; BECqUEREL
in 30 cases of meningitis, found tubercular granulations in the
membranes of the brain in no less than 28; JACKSON found
them in 4 cases out of 6; GREEN discovered them in 56 cases
out of 60; RILLIET and BARTHEZ in 29 cases out of 33; BouCHUT in 6 cases out of 9. Hence in 138 cases of so called
acute hydrocephalus, tubercles were found in no less than 123
instances.  Hence it is evident that until within a few years,
tubercular meningitis, simple acute meningitis, independent of
tubercularization, and simple dropsical effusion within the
cavity of the skull, independent of inflammation have been confounded together under the single term  of hydrocephalus or
water on the brain.
Symptoins.-Unlike acute simple meningitis there is more or
less of a premonitory stage. According to WEST, in the first or
premonitory stage there are many indications of cerebral congestion, coupled with general febrile disturbance; and presenting exacerbations and remissions at irregular periods.  The
child becomes gloomy, pettish and slow in its movements, and is
but little pleased with its usual amusements.  Or, at other
times its spirits are very variable; it will sometimes cease suddenly in the midst of its play, and run to hide its head in its
mother's lap, putting its hand to its head, and complaining of
headache, or saying merely that it is tired or sleepy, and wants
to go to bed.  Sometimes, too, it turns giddy, as may be known,
not so much from its complaint of dizziness, as from its suddenly standing still, gazing around for a moment as if lost, and




TUBERCULAR MENINGITIS.                   25
then either beginning to cry at the strange sensation, or seeming to awake from a reverie, and at once returning to its play.
The infant in its nurse's arms betrays the same sensation by a
sudlden look of alarm, a momentary cry, and a hasty clinging to
its nurse.  If the child can walk, it may be observed to drag
one leg, halting in its gait, though but slightly, and seldom so
much at one time as at another, so that both the parents and
the physician may be (lisposed to attribute it to an ungainly
habit which the child has contracted.  The a)pp::ac is usually
bad, though sometimes very variable, and the child, when apparently busy at play, may all at once throw down its toys and
beg for food; then refuse what is offered, or taking a hasty bite,
may seem  to nauseate the half-tasted morsel, may open its
mouth stretch out its tongue, and heave as if about to vomit.
The thirst is seldom considerable, and sometimes there is an
actual aversion to drink as well as to food, apparently from  its
exciting or increasing the nausea.  The stotmach, however, seldom rejects everything, but the same food that occasions sickness at one time is retained at another.  Sometimes the child
vomits only after taking food; at other times, even when the
stomach is empty> it brings up some greenish phlegm, without
much effort, and with no relief.  These attacks of vomiting
seldomr occur oftener than two or three times a day, but they
may return for several days together, the child's head probably
growing heavier, and its headache more severe.  The bowels
are generally constipated from  the first; the evacuations are
usually scanty, sometimes pale, often of different colors, almost
always deficient in bile, frequently mud-colored and very offensive.  The abdomen is seldom  full or distended, but the child
sometimes complains of pain in the belly, which may be tender
to pressure.  The tongue is not dry, generally rather red at
the tip and edges, coated with white fur in the centre, which
becomes yellowish towards the root; occasionally WEST has
seen it very moist, and uniformly coated with a thin white fur.
The skin is harsh, but there is no great heat of surface.  The
nostrils are dry; the eyes lustreless; the pulse accelerated,
but seldom exceeding 120 in children of four years old and upwards, not full and strong, but often unequal in the force and
duration of its beat.




26               TUBERCULAR MENINGITIS.
The child is apt to be drowsy, and will sometimes want to be
put to bed two or three times in the day; but it is restless,
sleeps badly, grinds its teeth in its sleep, lies with its eyes
partially open, awakes with the slightest noise, or even starts
up in alarm without any apparent cause.  At night, too, the
existence of intolerance of light is often first noticed in consequence of the child's complaints about the presence of the
candle in the room.
WEST truly says, that we must not expect to find all these
symptoms in every case, neither indeed, when present are they
persistent, but the child's condition is very apt to vary greatly
in the course of a few minutes; cheerfulness alternating with
depression, and sound sleep being now and then enjoyed in the
midst of the unrefreshing dozes of the night.
HARTMANN says, the precursory stage does not offer any of
the characteristic symptoms of acute d(ropsy of the brain. Thus
the child, which was previously able to run about with ease, has
an unsteady vaccillating gait; he raises his feet high from the
floor, or is liable to fall on the level ground, even in the room.
This unsteadiness communicates itself to the whole body. We
observe, moreover, a sudden change of disposition; in the place
of the former cheerfulness and lightness of heart, the child is
apt to become morose and peevish.  On moving the head suddenly, or raising it from the recumbent posture, vertigo or a
sense of stupefaction is experienced. In some cases the secretion of urine is scanty, in others it is turbid, flocculent or opalescent.  Some authors number a fine, dry, colorless eruption on
the outer side of the upper arm, on the cheeks and lips among
the precursory symptoms of dropsy of the brain.
Besides these symptoms there are others which are more or
less characteristic; such as a loss of the previous blooming appearance; restless sleep duringo which the child is apt to moan,
groan, start up as in a friight, alternations of creeping chills and
flushes of heat; a pulse of the ordinary rapidity, but one which
intermits at times, or beats irregularly or more feebly.
If many of these symptoms be present, the physician should
be led to suspect the impending approach of dropsy of the brain
and to watch the development of the symptoms with anxious
and redoubled attention.  If the child be descended from scrofu



TUBERCULOSIS.                     27
lous or consumptive parents it may already be too late to save
life; the tuberculous dyscrasia may already be so fully developed, or the blood be already so fully overloaded with tubercular matter, or the capillary vessels may have lost their power
and function of forming or separating healthy materials from
the blood, that it will be impossible to prevent the formation
and deposition of tubercle in the membranes of the brain, or
even in many other organs.  Still the trial must be made, late
though it be.  But in order to treat the tuberculous tendency
or dyscrasia with the faintest hope of success, we must first understand, thoroughly understand, of what tubercle consists, and
what it really is.
TUBERCULOSIS.
TUBERCLE.
THE physical description of tubercle is well known to every
physician, the chemical is not so. According to HASSE, who
drew his conclusions from numerous analyses carefully compiled
by CERRUTTI and VOGEL, the organic component parts of tubercle are principally Caseine, with some fat, and a little albumen. According to PREUSS the animal portion of tubercle is
principally made up of Caseinae, with some fat in the form of
Cholesterine, and a trifle of Phymatine.  GiiTERBOCK found
much Caseine, some Albumen, Phymatine and fat.
Less accurate observers, such as THENARD, found Albumen in
excess; while HECHT and SCHARLAU. who probably did not
separate the cellular and other tissues, or products of inflammation found intermixed with the surrounding tubercular masses,
found nearly equal proportions of Gelatine, Albumen and Fibrine, in their analyses of tubercular substance.
ANCELL, justly says, if we admit that tubercle is a definite
chemical compound, which is very probable, still this compound
must be subject to changes and to admixture with numerous
extraneous and accidental materials, as with those composing
the tissues in which the tubercle is deposited, and which by
pressure and otherwise, become disintegrated and blended with
the essential constituents of tubercle, or with the products of
inflammation, such as coagulable lymph, or fibrine, or pus from




28                     TUBERCULOSIS.
inflammation of the substance of the tuberculous organ, or with
mucus or pus from the mucous membrane of the lungs, or with
blood itself. It is always difficult, and frequently impossible,
for the chemist to separate these different products, or to estimate their prop( Jions.  Tubercle must also, from  the same
causes, exhibit differevces, according to the nature of the tissue
in which it is seated. Still, he says, chemical analysis leaves no
doubt that tubercle contains a protein compound as an essential
constituent, which appears to bear a close analogy to, if it be
not identically Caseine.  Tubercle has a decidedly cheesy appearance to the naked eye, and tuberculous pus resembles a
mixture of soft cheese and water both in color and consistence.
ANCELL repeats that the caseous quality of tubercle and scrofulons pus indicates the presence of a nitrogenous compound  of a
caseous nature in the liquor tuberculi, showing that from  the
liquor sanguinis of tuberculous blood a caseous blastema is exudedl, differing from  the ordinary healthy blastema.  Its caseous
quality renders it unfit to nourish thle tissues, and gives it a
tendency to solidification.
Another large class of medical chermists think that tubercle is
essentially albuzminous in its nature.  Thus IHECHT found in
crude tubercle: Fibrine 30 parts; Albumen 23; Gelatine 27;
water and loss, 27., BoUDET found: Caseine, Gelatine and a
considerable quantity of Cholesterine; when tuberculous substance was treated with cold water it yielded: Albumen, a substance resembling Caseine, and a fibrinous residue.  GiiTERBOCK found: Pyine, Phymatine, Albumen and fat. SCHARLAU,
Albumen, Gelatine, Fibrine, fat and water.  VOGEL, Fibrine,
Albumen and Caseine, with fat, a imaterial analagous to Pyine,
&c.  GLOVEa, Pyine, Albumen, (but no Caseine,) fat, &c.
L'IHERETIER found softened tubercle to consist of Albumen,
very soft Fibrine, fatty matter and lime.
It is easy to account for many of these discrepancies; thus
PREuss in the most complete chemical analyses of crude tubercular pulmonary substance which has yet been furnished, found
Gelatine in the residue of the pulmonary tissue, which he carefully separated from  the tuberculous substance, but none in
tubercle itself. If other chemists had been equally careful,
they probably would not have found much or any Gelatine in




TUBERCULOUS BLOOD.                      29
tuberculous matter. Again, ANCELL says that Pyine is by no
means a constant constituent of tubercle; it is a trit-oxide of
Protein, the result of inflammatory action on tuberculous blood
resulting in the super-oxidation of the Protein compounds, such
as Caseine, or possibly Albumen or Fibrine, which make up the
bulk of tubercle. The Fibrine is also probably the result of
inflammation, hence, we can easily narrow down the two essential constituents of tubercle to Caseine and Albumen.
Caseine and Albumen are analagous substances; both are
comIounds of Protein; Albumen consists of 10 atoms of Protein, 2 atoms of Sulphur and I of Phosphor.; while Caseine
consists of 10 atoms of Protein, 1 of Sulphur a.nd none of Phosphor.  Hence it is very easy for careless or not very expert
chemists to mistake one for' the other.
TUBERCULOUS BLOOD.
As tubercle is evidently derived from the blood, we lhave next'to examine the character of the blood in tuberculous subjects.
According to ANCELL tuberculous blood is defective in vital
properties; the red globules are deficient in number and defective in structure; the globulin, hllmatin and iron are all
deficient.
The serumn of the blood is vitiated in quality, the -water,
Albumen and lime are in excess, and the Albumen also defective in quality.  Caseine does not exist normally in the blood,
and hence the defect in the Albumen may consist in its tendency to be converted into Caseine.
The Fibrine is rather deficient in quantity and defective in
quality, the fats probably deficient; the alkaline and earthy
salts, especially the chlorides and phosphates of Soda and
Potassa decidedly deficient.
DIETETIC TREATMENT OF THE TUBERCULOUS DYSCRASIA.
Hence the indiciations for the improvement of the quality of
tuberculous blood, are: 1st, to increase the quantity of iron, fat,
alkaline- and earthy-salts and Fibrine, and to improve the quality of tile latter; 2d, to diminish the quantity of water, lime and
Albumen, and improve the quality of the latter.




30                DIETETIC TREATMENT OF
As blood is formed from the food by the processes of digestion, chymification, chylification and sanguinification, tuberculous blood may be produced from improper food, by a peculiar
form of indigestion, or by a defect in sanguinification in the
lungs or other parts of the body.
In tihLe first place vegetable Albumen, according to MULDER
is perfectly identical with animal Albumen, and hence it is
probable that the whole quantity of Albumen required for the
purposes of the body is delivered to it already formed, and does
not require to be elaborated by the processes of digestion or
sanguinification.  Great care should be exercised in the selection of the albuminous articles of food for consumptive persons,
that they be of the best quality; as there is already a tendency
to excess of Albunien in tuberculous subjects, articles of food
should be selected which contain comparatively little of already
formed Albumen.  According to PaOUT the following quantities
of Albumen are found in the subjoined animal substances.
East India Isinglass,  -    -    7.2 to 13.5 per cent.
White of Egg,   -    -                 15.5    "
Yolk                             "     17.47 
Liver of Ox,     -    -    -           20.19
Sweetbread,                            14.00   "
Caviare,         -          -    -     31.00   "
Hence the above articles are more or less objectionable in
the diet of scrofulous, tuberculous or consumptive persons.
The muscle of Beef contains only,  -    2.2 per cent.
i4'?Mutton              -    2.6    "
Venison     "       -    2.3::Veal       a      2.6 to 3.2    "
Chicken'       -    3.0    "
Fish       "      4.4 to 5.2    "
Pigeon              -    4.5    "
Hence, beef, mutton, venison and chicken form the best animal food for tuberculous subjects.
Again, as the Fibrine of the blood is defective and deficient,
articles of food which contain much Fibrine should be selected.
The muscle of Beef contains       20 per cent. of Fibrine.
" 4      lMutton  "        22    "
t4 4   Chicken "           20    "




THE TUBERCULOUS DYSCRASIA.                  31
The muscle of Veal contains       19 per cent. of Fibrine.
"      Pork      "         19      "'       "
"  Fish   I"  from 13 to 15 "'      "
Sweetbread, only    8
Again, articles which contain Caseine should be avoided in the
diet of tuberculous persons-milk, curds and cheese are objectionable, cream and whey are allowable. Asses' milk is the least
objectionable as it contains only 1.82 per cent. of Caseine, while
cows' milk contains as much as 4.48.  The milk of cows fed on
hay, turnips and potatoes contains only 3.3 per cent. of Caseine,
and is perhaps less injurious than some other kinds.
Vegetable Caseine is chiefly found in the leguminous seeds,
such as beans, peas, lentils, &c., hence these may have to be
avoided.
Vegetable Albumen is present in considerable quantity in
most vegetable juices, such as the juices of carrots, turnips,
cabbages, cauliflowers, asparagus, &c. —Potatoes contain far
less Protein and Albumen than any other vegetable substance
used for food,-only 1 per cent.
Vegetable Fibrine is most abundant in the seeds of the cereal
grasses, such as wheat, rye, barley, oats, maize, rice; it also
exists in buckwheat; the juice of grapes is especially rich in
it, &c.
As the fat is deficient in the tuberculous dyscrasia, the oily
alimentary principles should be used.
Filberts contain   -    -    -    60 per cent. of oil.
Walnuts'       -    -    -    50
Olive seeds       -    -    -    54    "
Cocoa and Earth-nuts   -    -    47    "         "
Almonds           -    -    -    46    " "
Maize      "      -    -    -      9    "        "
Dates     "       -    -    only.02''
Yolk of Eggs      -    -    -     28.75  "
Ordinary meat, with cellular tissue 14.3. 
Liver of Ox       -          only  3.89  "
Caviare           -    -      "    4.3   "
Cow's Milk        -    -'         3.13  "
Asses C                       S.11.




32              TUBERCULOUS INDIGESTION.
Butter and olive oil, fats, meats and marrow may be used,
suet puddings, salmon, herrings and eels abound in oil, chocolate and cocoa, hashes, stews and broths contain much fat.  As
the fixed oils and fats aredifficult and slow of digestion many
physicians may consider them objectionable.  It is well known
that in many delicate persons fat does not become properly
chymified.  It floats on the contents of the stomach in the form
of an oily pellicle, becoming odorous, and sometimes highly rancid, and in this state excites heartburn, most disagreeable nausea,
and eructations, or at times actual vorniting.  These effects are
owing to the development of volatile fatty acids, and may be
prevented by the use of alkaline and earthy salts, such as the
chlorides and phosphates of Soda and Potassa which are also
required to make up the deficiency of them, which has been shown
to be present in the blood of tuberculous subjects.
As the'ron of the blood is also deficient, a certain quantity
must be supplied to the system.
TUBERCULOUS INDIGESTION.
Such is the theoretically correct system of diet in tuberculous
dyscrasia and affections; but it is very evident that healthy
anirnal or vegetable Caseine or Albumen will not be converted
into tuberculous Caseine and Albumen if all the functions of
digestion and sanguinification be perfectly and healthily performed.  According to BENNETT, many observing physicians
have not failed to notice that tubercular disease is ushered in
%vwith a bad or capricious appetite, a furred or morbidly clean
tongue, unzusual acidity of the stomach and bowels, loss of
appetite, constipation alternating with diarrhcea, and a variety
of symptoms denominated dyspeptic, or referable to a deranged
state of the digestive organs.  It is probable that tuberculosis
is a disease of the primary digestion, causing, 1st, impoverishment of the bloodl; 2d, local exudations from the bloodvessels
presenting the characters of tuberculous exudation; and third
the consequent softening, ulcerations and destructive results
which distinguish it.  BENNETT also asserts that further observations show, that circumstances which remove the malassimilation of food frequently check further tubercular exuda



TUBERCULOUS INDIGESTION.                 33
tions, while those which previously existed become abortive, and
that occasionally more extensive excavations may heal up and
cicatrize.
A healthy nutrition of the body cannot proceed without a
proper admixture and proportion of the albuminous and oleaginous elements. This may be inferred from the physiological
experiments of TIEDEMANN, GMELIN, LEURET, LASSAIGNE, MAGENDIE and others; from an observation of the constituents of
milk, (caseine, butter and sugar,) the natural food of young
inammiferous animals; from a knowledge of the contents of the
egg, (albumen and oil,) which constitute the source from which
all the tissues of oviparous animals are formed before the shell
is broken; and from all that we know of the principles contained in the food of adult animals.
The peculiarity of tuberculosis, however, is that an excess of
acidity exists in the alimentary canal, whereby the albuminous
constituents of the food are rendered easily soluble, whilst the
alkaline secretions of the saliva and of the pancreatic juice are
more than neutralized, and rendered incapable either of transforming the carbonaceous constituents of vegetable food into
oil, or of so preparing fatty matters introduced into the system,
as will render them  easily assimilable. In consequence, more
albuminous than fatty matters enter the blood, and the necessary
waste of structure is supplied by the absorption of the adipose
tissues of the body. Hence the emaciation which characterizes
tubercular disease; hence also, as the fatty matters introduced
into the stomach are not digested and assimilated, but are simply taken up into the vena porta and carried to the liver, the
fatty liver which occurs so frequently in the tuberculous dyscrasia. In the meanwhile local congestions occur in various
parts, leading to an exudation containing a super-abundance of
albumen; which in its turn being deficient in the necessary
proportion of fatty matter to form elementary molecules, remain
abortive and form tuberculous corpuscules.
To improve the faulty nutrition which originates and keeps
up the tubercular disease it is of all things important, therefore,
to cause a larger quantity of fatty matter to be assimilated.
The use of alkalies or other solvents or digestives of oil are allimportant, although a mere increase in the amount, or even'~I"' ~^"r   w^" c




84               TUBERCULOUS MENINGiTIS
quality of the food will often accomplish this.  The treatment
practised some years ago by Dr. S TEWART, which consisStec in
freely administering beef-steaks and porter, and causing exercise to be taken in the open air, excited considerable attention
friom  its success.  BENNETT has been informed, that in some
parts of America the cure consists in living on the bone-marrow
of the bu-ffalo, andcl that the consumptive patient gets so strong
in this way, that lhe is at length able to hunt down the anirmal
on the prairies.  All kinds of food, rich in fat, will not unfirequently produce the same effects, and hence the value long attributed to milk, especially ass's milk, thie produce of the dairy,
as cream  and butter, fat bacon, ca!viare, &c.
But, in order that such substarnces should be digested or
assimilated, solvents of fat (alkalies) must be used, if the powers
of the stomach and alimentary canal have undergone any grea-t
diminution.  Unless this precaution be used, it will be,  ald in 
many cases that the patient is unable to tolerate such kind of
food, and that it either lies undigested in the stomach, or is
sooner or later vomited.
Children born of tuberculous miothers should  be weaned
early; unless a perfectly healthy and robust wet-nurse can
be procured it is better to feed them with dilutLed or undiluted
creamrn
FULLY  DEVELOPED  TUBERCULOUS M:,ENINGITIS
Is marked by three important symptoms, viz.: by headaclhe,
vomiting and conistipation, to which is added in the great
majority of cases, some acceleration of the pulse; the intelligence may remain perfect, showing that the brain itself is not
yet involved; the strength may not be greatly dinminished, nor
the appetite entirely lost, and the thirst may be moderate.
These symptoms usually last but two or tihree days before
others make their appearalnce, showing that the attack is confirmed.  In some few instances, however, the precursory symptonms last, with irregular intermissions, for several weeks.  In
some cases the invasion may be preceded for three monthls by
occasional cough, irregular attacks of fever, progressive emnnciation, paleness, languor alternating with extreme irritability,




TUBERCULOUS MENINGITIS.                    35
disinclination to take exercise, and during the latter part of the
time by partial lameness, and in fact by all the signs of general
tubercular disease.  In other cases the invasion may be preceded for several months by frequent complaints of intense
headache, especially after taking active exercise, and by unusual
languor, and by no other symptoms; there may be long intervals of health, and the child then be taken down suddenly.
According to MEIGS, headache is a nearly invariable symptom  in children old enough to describe their sensations, and is
therefore very important. In infants its presence is to be inferred when the child frequently carries its hands to various
parts of the head, and presses strongly against it, and when the
head is constantly rolled from  side to si(le.  It is usually re —
ferred to a point just over one or both brows; in other cases it
extends over the whole head.  It is commonly severe so that
the child, when old enough, complains of it spontaneouslyr  they
may even cry frequently and bitterly, beg tow have the doctor.
sent for, and submit willingly to any remedCy suggested for its
relief.  It is thought that the acute shrill cry of the disease
depends upon the acuteness of this pain.  It  usually lasts
throughout the first stage, and ceases only as the delirium and
coma of the second stage come on.
As long as the membranes of the brain are alone involved the
headache is not attended with delirium.  In truth -the intellectual faculties remain undisturbed in the majority of cases
during the first few days; and this fact, which is so contrary to
what is generally supposed, is apt to mislead the physician in
his opinion and treatment of the case; he is generally too apt
to give remedies which act more specifically upon the brain,
than upon its membranes.
I trust that it has been rendered evident that a correct system  of diet is as necessary in tuberculosis as in diabetes or
adiposis.  There is frequently time sufficient to make the tria],
for the healthy and robust are comparatively seldom  attacked
by dropsy of the brain, and in many instances the evidences of
declining health, precede for weeks or months the real premonitory symptoms of the disease.  We often observe atr gradual
decay of the child's strength and wasting of its flesh, it becomes
subject to irregular febrile attacks, coughs a little, loses its




36               TUBERCULOUS MENINGITIS.
appetite, its bowels are almost always disordered, and generally
constipated, it makes frequent vague complaints of pains in its
limbs, or of weariness or headache.
Medical treatment.-I-IARTMANN correctly states that one
of the most homoeopathic remedies for the precursory stage
of tubercular meningitis is Pulsatilla; it corresponds more
especially to the derangement of the stomach, to the inability
to digest rich and fatty food, to the gradually failing health,
loss of flesh and ill-conditioned look, to the tottering gait, the
vertigo, and deranged secretion of urine, to the headache, nausea and vomiting.  Still it is not positively known to have a
specific curative relation to the albuminous or tuberculous dyscrasia.
Elepar-sulphur. deserves great attention when the albuminous excess, or dyscrasia is fully developed, at least, according
to SOBERNHEIM  it renders the pulse softer and slower, the
blood darker and decidedly deficient in albumen; its powers
in this respect aire so decided that HARTWIG asserts, in half an
hour after taking Hepar-sulph. in massive doses, the blood of
horses will be found from three-fourths to four-fifths deficient in
albumen.  When small doses fail, the following prescription
may be used:
Hepar-sulphuris,          grs. 18.
Cocoa Butter,         drachms 2.
White Sugar,             a      3.
Oil of Almonds,          ounce ~.
One or more tea-spoonsful per dose.
This prescription will meet many of the requirements in the
tuberculous dyscrasia, viz.: the alkaline, oleaginous and antialbuminous treatment. Busch of Strasburg, has cured several
cases of confirmed tubercular consumption, with Aconite in the
first stage, and Hepar-sulphuris in the subsequent periods.
Prof. BANG, of Copenhagen, has had similar good fortune; also
Dr. HAREL DE TANCREL.
Treatment of the headache. —If fever and other symptoms
of inflammation be present, Aconite will be the most important
remedy. It may be given internally in the usual doses; besides, as the seat of the disease is at the base of the brain,
Aconitine ointment, (from 1 to 4 grains to the half ounce of




TUBERCULOUS MENINGITIS.                 37
simple cerate,) may be rubbed behind and below the ears, and
on the back of the neck where it joins the head; or Tincture
of the PRoot may be applied freely in the same localities, every
two, four or six hours, according to the severity of the symptoms. In simple acute meningitis these remedies should be
applied to the top of the head.
The next most important remedy is Belladonna or Strramnonium; they may be given internally; and the Extracts or
Tinctures may be used externally, as directed for Aconite.
If these fail to afford relief, Hyosciamus or Opium may be
used both internally and externally; as soon as the physician is
decided in his opinion that the case is one of Tubercular Meningitis, and hence almost necessarily hopeless, his principal endeavors should be directed towards soothing the sufferings of
the patient.
But Glonoine should be tried faithfully before palliative
remedies are given; especially when there is violent congestion
to the head, throbbing in the forehead, temples and vertex, violent beating of the carotids, redness of the face, quickness of
the pulse, &c.
Vomziting is the next most important diagnostic symptom,
and almost a constant one; BARRIER found it absent in only
15 cases out of 80, or in less than a fifth. It generally makes
its appearance on the first day, rarely later than the second or
third, and lasts two or three days, and sometimes longer; it
may, however, last ten or twelve days; the matters ejected consist of food, mucus and bile in various proportions; it is commonly repeated two or three times a day. The vomiting is
often, although not always, of a peculiar character, viz.: projectile, i. e. it occurs without much or any nausea, and the contents of the stomach are propelled suddenly with great force,
often to the distance of several feet from the person of the
patient. The vomiting may arise from irritation of the Pneumogastric nerve at the base of the brain; or from commencing
disease in the Corpus-striatum, (see treatise on headaches,
p. xiv.); or from gelatinous softening of the stomach.
Treatnent of thLe vomiting.-This may subside under the
use of Aconite or Belladonna. If these fail, Cuprum or Zin



38              TUBERCULOUS MENINGITIS.
czmn are best suited to the peculiar spasmodic vomiting, attended with little nausea.  Zincum is also supposed to exert a
specific action on the brain, (see treatise on Mental Derangemrent, p. xxiv.) and HARTMANN says it is very useful in the
first stages of the disease, when the children become irritable
in thile evening, are somewhat delirious during their sleep, but
become more quiet after midnight, and are quite bright again
towards morning; also when the bowels are costive, violent
headache sets in, the eyes become sensitive to light, the nose
dry, retching, vomiting and insatiable appetite occur, the urine
becomes scanty, turbid and loam-colored, with evening fever,
frequent pulse, heat and anxiety, and twitchings of the muscles.
Zinc has also a well-established reputation against many subacute and chronic inflammations, many nervous and spasmodic
affections, such as asthma, St. Vitus' dance, epilepsy, convulsions of children, constipation, flatulence, &c.
In vomiting from softening of the stomach, Kreosote is the
best remedy.
Constipation is said to be even a more important symptom:than vomiting; according to BARRIER it is absent in only 7
cases out of 87; it generally persists obstinately for several
days; and sometimes is not present at the very beginning of
the disease, but sets in soon afterwards.  It generally depends
upon the disease at the base of the brain, more especially seated
in the Corpora-quadrigemina, (see treatise on headaches, p. xiv.)
Treatlm ent.-In children predisposed to dropsy of the brain,
the condition of the bowels must be most carefully watched,
constipation must not be allowed to exist even for a day, and
the least indication of gastric disorder must be regarded as a
serious matter. If constipation has already been present for
several clays before the physician is called in, some simple but
efficient purgative or injective medicine should be given at once.
WYhen this has been done, Zincumr and Opium will probably keep
them regular; at least Dr. STRONG, (allopathic physician) ably
advocates the use of Zinc and Opium in flatulence, and in constipation.  WEST t'hinks that the value of purgatives in the
treatment of ordinary hydrocephalus can scarcely be overrated;
but he says that they must be given so as not merely to obtain
free action of the bowels, but to maintain it for some days.  In




TUBERCULOUS MENINGITIS.                    39
tubercular meningitis any very harsh and active measures for
this purpose are entirely misplaced and useless.
The urinze is scanty, frequently turbid and cloudy in the first
stage; afterwards it im-ay deposit a chalk-like sediment, and
finally it is passed involuntarily.  Other authors say that it is
apt to be of a deep amber hue, of high speciic gravity, sometimes milky depositing a slimy sediment, and it is apt to smell
offensively after being passed and to cause pain in the urethra.
In simple meningitis or phrenitis, the urine is of a dark-brown
or porter-color, containing an excess of urea and less of lithates;
the sediment is generally reddish or reddish-brown.
Again hydrocephalus has been known bo commence and proceed to the last stage with scarcely any other symptom  than
slight fever, with little or no pain in the hlead, but a constant
and nearly ineffectual desire to pass urine; in one case not above
a gill of urine was passed in twenty-four hours for five days,
and no other symptom of consequence was present. MoNRO and
JEBERLEE have observed such cases.
On the other hand GUERSENT observed five cases in which
the profufse secretion of urine was quite remarkable, and in
these tubercles were found in the kidneys in every case.
Treatment of the urbiary disorder. —Many physicians think
that the peculiar milky urine, with chalk-like or slimy sediment
indicate an endeavor on the part of nature to drain off some
noxious substance from  the blood: if this be the case, Phosphoric-acid will prove the most homoeopathic remledy to milky
urine, with gelatinous lumps, or appearing as if flour were
stirred in it.  This remedy is also indicated against softening
of the stomach.
Carbo-vegetabilis, and Iodine when the urine is thick and
milk.y.
C/tin.-sulph., when there are slimy flocculi, and a clay-colored
greasy sediment.
Tart.-emiet. when it is pale, with a flour-like sediment.
WRtzhus-to'., pale urine with a snow-white sediment.
Zinculn, when it is turbid and clay-colored.
l'fitriatic-acid, when it is white and turbid like milk when
passed.
C/hina,  when it is white and turbid, with a white sediment.




40               TUBERCULOUS MENINGITIS.
Graphite, when it is turbid, with a white sediment.
Dulcamara, when it is turbid and white.
Mercurius, when it is turbid as if stirred with flour; or
clear at first, and then becomes white as if mixed with chalk,
with burning in the urethra.
Zincurn, yellow urine, depositing whitish flocculi.
Some physicians think it very important that there should be
a free flow of urine, and erroneously suppose that the brain is
safe as long as the kidneys act freely, (see above).
Among the brain remedies, Belladonna produces a free flow
of urine.  Dr. I-I. M. GRAY thinks that it exerts a tremendous
diuretic power; is confident that its power over the secretion
of urine is very great, as he passed three pints of urine in the
course of an hour, attended with slight strangury, while under
its influence.
Cantharides is perhaps the most homceopathic remedy to
meningitis, and its action upon the kidneys is well-known; it is
most indicated when the urine is full of mucus, with flocculi and
filaments, or mixed with sand or clots of blood.
Arnica, when clear urine soon becomes white and turbid.
Zincum has already been alluded to.
If these remedies fail Digitalis and hydrodate of Potash will
almost certainly produce a free flow of urine, but that will very
often not ward off a fatal termination.
The next most important symptoms are observed in the pulse
and respiration; they do not accord; the pulse is apt to be
rapid at first and the respiration disproportionably slow; irregularity of breathing is often noticed by an attentive observer,
long before there is any irregularity of the pulse; one, two or
three respirations may be taken at equal intervals, but the
breathing is apt to be quite superficial, the upper ribs only
slightly rising and falling, but then there comes a full deep inspiration, very often attended with a sigh: again, there are one,
two, three or four, superficial inspirations followed by a deep
loud one. At other times the inspiration is quick, hurried and
convulsive, followed by a marked increase in the duration of
expiration and the period of repose; the inspiration is considerably shortened and a deep prolonged sighing often supervenes,




TUBERCULOUS MENlNGITIS.                  41
and considerably diminishes the amount of respiratory movements.
In the first stage the pulse is much accelerated, full but compressible, with a perceptible variation in the rythm of the artery, and in the regularity of the strokes; the pulse sometimes
beating as quick during one-third of a given time as it had previously done during the former two-thirds; thus, in a pulse of
140, one-half, or 70 strokes may be performed in 40 second,
and the other 70 in 20 seconds. This is often noticed before
there is any intermittence noticed.  Then some slight intermission will be noticed every 7th, 17th or 20th stroke; finally
the pulse will begin to change its character, one or two strokes
in quick succession being soft, weak and fluttering.
In the second stage the pulse becomes slow, labored, intermitting and irregular, but is easily quickened by motion or
mental disturbance to double its previous amount of pulsations.
If the pulse beat only 60, 80 or 90 per minute, we may be certain that life will last for some days; but as soon as a new
acceleration ensues, death will occur in two or three, or at most
in five or six days. In the second quickening of the pulse it
generally rises to 112 or 120 on the first day, and will be from
140 to 160 on the very day of death, it increases in frequency
up to death.
The pulse always begins to become slow after the headache
and vomiting have lasted sometime, and before somnolency sets
in; it falls from 120 or 140, to 80 or even as low as 54.
These alterations in the breathing and pulsations are doubtless produced by irritation, followed by pressure upon the parvagumr at the base of the brain.
Treatment. —Mercurius-corrosivus is indicated  when the
breathing is difficult and irregular.
Belladonna, when the respiration is natural at times, at
others almost extinct; also when it is labored, irregular, sometimes hurried, at others slow.
Opium, when the inspirations are slow, long or sighing; or
the breathing is irregular and suffocative; or deep and strong,
followed by difficult and feeble breaths.
Stramonium, when the inspirations are slow, followed by
sudden expirations, with frequent sighing.




42               TUBERCULOUS MENINGITIS.
Camjphor, when the breathing is slow and deep.
Lactrocerasus and -Hyydrocyamic-acid, when it is slow, moanng  and rattling.
Iodine and Spongia, when it is slow and deep, as after exhanstion.
Aconite, when it is slow during sleep.
Nitric-acid, when slow and feeble, with wheezing.
Scilla, when it is slow and heavy.
Lobelia-inQfata, when there is an inclination to sigh.
As regards the Pulse:
Belladonrna is indicated when it is quick and strong, or slow
and full.
Aconite, when it is slow irregular and intermitting.
Opium, when slow and full, afterwards becoming weak.
AStramoniumn, when irregular, frequent, quick; intermittent,
tremulous and weak.
Laurocerasus, when irregular, slow, down to 80.
Digitalis, when irregular and small; irregular and unequal,
or slow; very slow, down to 35 or 40; intermitting and slow.
Agaricus, when it is unequal, slow, feeble and intermitting.
H.yosciamrus, irregular and weak; intermittent, small and
quick; falling from 80 to 59.
Cttpriun, irregular, simall and contracted.
Coniurn, unequal in strength and quickness.
Secale, irregular, at times slow and full, then small and contracted; intermittent, slow and small.
Tartar-eymetic, irregular and weak; slow, down to 50.
Tobacco, slow, small and intermitting; down to 45, and very
weak.
fiercurius, irregular and small; feeble, slow and tremulous.
Plumnbuz, irregular, first quick, then slow; sluggish and intermittent.
Phos. and Nitric-acid, irregular and intermittent.
l uriatic-acid, intermitting every 3d beat.
Hellebore, slow and very small.
Coog-h. —A slight false cough which partly resembles a suppressed effort to vomit, and not unlike the morning liver cough




TUBERCU.LOUS MENiNiGITISo                 43
of drunkards, is not unfrequent in all three stages.  When it
occurs in conjunction with the peculiar breathing before described, it is supposed to be a sign of effusion in the ventricles.
It may depend upon irritation of the pneumo-gastric nerve at
the base of the brain; or upon the deposit of miliary tubercles.
Treatment. —It is stated that nothing will relieve it; but
Conium is often a useful remedy.
Retractionz of the abdomen is a valuable diagnostic sign; it
usually occurs about the sixth day; the belly becomes depressed
at its centre and takes on the formin  of a boat; it is almost a
constant symptom, and does not arise from the constipation, as
it is equally present when diarrhea sets in; it is almost peculiar to this disease of the brain.
Treatzenzt.-Plumbum and Zincum are the most homoceopathic remedies, although Nux, Ignzatia, Angustura, Alumina and
Colocynth may seem to be indicated.
I have been in the habit of placing great stress upon the
presence of stiff neck, occurring every afternoon or evening, and
disappearing in the morning. It probably arises from irritation
at the base of the brain, near the origin of the twelfth pair of
nerves, as this supplies the muscles of the nape of the neck and
shoulders.  If this symptonm occur in a person born of tuberculous or consumptive parents, and is attended with headache,
fever, vomiting, constipation and signs of irritation of the brain,
it always excites our liveliest apprehensions as to the result.
Tireatment. Zincum  and Plurmbum are the best remedies.
The precursory stage above alluded to is of variable duration,
but on the average does not exceed four or five days.  When
the second stage sets in, the nature of the affection becomes very
apparent.  The child no longer has intervals of cheerfulness,
nor attempts to sit up, but wishes to be left quiet in bed, and
the face assumes a permanent expression of anxiety and suffering.  The eyes are often kept closed, and the eyelids are knit,
the child endeavoring to shut out the light from  its imorbidly
sensitive retina.  The skin continues dry, the face is sometimes
flushed, and the head often hot; and though these two symptoms vary much in their duration, coming and going without




44               TUBERCULOUS MENINGITIS.
any evident cause, yet there is a permanently increased pulsation of the carotids, and if the skull be not ossified, the brain
may be seen and felt forcibly beating through the anterior fontanelle. The child is now very averse to being disturbed, and
often lies in a drowsy condition, unless spoken to; when old
enough to answer, it usually complains of its head, or of weariness or sleepiness. Its replies are generally rational but short;
and if it needs anything, it asks in as few words as possible, in
a quick, pettish manner, and shows much irritability, if not at
once attended to. At other times it lies with its face turned
from the light, either quite quiet, or moaning in a low tone of
voice, and now and then uttering a short, sharp, lamentable cry,
which is regarded as characteristic of the disease, and hence
termed the cry hydrencephalique.  To this, however, there are
exceptions, and children sometimes scream out with the intensity of the pain.  As night comes on, there is almost always a
distinct exacerbation of the symptoms, and the quiet of the day
is frequently succeeded by a noisy and excited state, in which
vociferous cries about the head alternate with delirium.  At
times, however, an increase of restlessness is the only difference
firom the state of stupor in which the child lay during the day.
At the commencement of this stage the pulse is quickened,
sometimes very much so. The child sometimes keeps its eyes
so firmly closed that we can scarcely see the state of its pupils.
Usually they are not much affected, but sometimes one is more
dilated and acts more sluggishly than the other; or, in other
eases squinting exists, though perhaps in a very slight degree,
or confined to one eye. It is seldom that vomiting continues
beyond the commencement of this stage, but its cessation is not
followed by any desire either for food or drink.  The bowels
usually become even more constipated than they were before,
and the evacuations continue quite as unnatural, while all flatus
disappears front the intestines, and the abdomen thus acquires
that shrunken form on which much stress has been laid by some
writers, as characteristic of dropsy of the brain.-WEsT.
Treatment.-In this stage Mercury and purgatives are generally given freely and barbarously by allopathic physicians.
But the most efficient allopathic remedies are a few small doses
of Mercury or Proto-iodide of Mercury, followed by IHydriodate




T'UfERCULO-US MENINGITIS.                 45
of Potash internally, aided by the free and frequent application
of Hydriodate of Potash ointment over the whole of the head,
and back of the neck.  In desperate cases Dr. HI]AHN has sever
ral times succeeded in arousing the child with the cold effusion,
after the supervention of complete coma.  Friction of the scalp
with Tartar-emetic ointment, repeated every two hours until
pustulation was established, enabled Dr. ItAHrU  to save fourteen
cases, when in an apparently hopeless state of coma; even in
tuberculous meningitis cures swere obtained in several cases by
the Tartar-emetic frictions under the most unpromising circumstances.
The third stage commences when the brain itself becomes
involved and becomes softened.  The transition is sometimes
effected very gradually by the deepening of the state of drowsiness, till it amounts to a stupor, from which it is impossible to
arouse the child. At other times, the stupor comes on very
suddenly, immediately after an attack of convulsions.  These
convulsions usually affect one side much more than the other,
and after the fit has passed offt one side is generally found
partially or completely paralyzed, while the child makes constant automatic movements with the other, carrying the hand
to the head, and alternately flexing and extending the leg.
The side which is the most affected during the fit, is generally,
though not invariably the most palsied afterwards. When the
third stage is fully established, the child lies upon its back in a
state of complete insensibility, with one leg stretched out, the
other drawn up towards the abdomen.  The tremulous hands
are either employed in picking the lips or nose until the blood
comes, or one hand is kept on the genitals, while the other is
rubbing the face or head. The head is at one moment hot, and
the face flushed, and then the heat disappears and the flush
fades, though usually there is an increase of heat about the
back of the head.  Sometimes the skin will be dry, at others
though the extremities are cold, a profuse sweat will break out
on some part of the body, or on the head.  The pulse becomes
regular again, but grows smaller and more rapid until it can
only be counted at the heart. The eyelids close only partially;
there is some squinting; light is no longer unpleasant, for the
dilated pupils are motionless.  The child now often makes auto



t  TUBEnRCULOUS MENINGITIS.
matic miovemeonts with the mouth as if chewing, or as though
endeavoring to scialwlow something, and it generally happens,
that although sensibility is quite extinguished, the little patient
will      still swallow  anythin  that is put into its mouth, and the
power of deulau ition is    most cases one of the very last to be
abolished. —-ESIT.
Mitany of tchesse symntom s are sometimes very stupidly regarded as signs of worm disease, and Cina and Spigelia or other
worm remedies are administered.  But these are signs of softeningo of the brain, and cannot be removed by any remedies,
althoauh'  Zlncum~, Plumbum,, ]N-ux and Arsenicumn are the most
apprlopiate medicines.
A   attaclk 0of onvulsions  now sometimes puts an end to the
painfal scene; but often the child lives on for days, though
wastsl  to a s keleton, ad it s features so changed by suffering
1      ot t tm!. e p'ersons Waho h1ad seen it but a short time before
-wo uld now'v scarcely reco',nize it.  The head often becomes retracted( and the child bores the baclk of its head into the pillow;
the eyelids are wide open, and the eyes are turned upwards, so
as to conceal three-fourths of the iris beneath the upper lid,
wlile t-, e countenance is still further disfigured by a horrible
sqciunt, or by   corstanut rolling  oe the ayes.  The pupils are
now fixed and glassy, tihe white of the eye is extremely bloodshot, and their surfrace besmeared with a copious secretion from
the -meibomian glands, -nhich collects in their corners.  One
1arin  n-nd  leo are stiff and motionless; the other in constant
spasmod- c -' rovement) whlille the hands are often clenchedl and
Ihe wArVi`5s benst  pon the forearm.  Subsultus and spasmodic
twxitcl:}io:ns   of the fice are common.  Cold clammy sweats break
out thic breathlino  is labored, swallowing becomes difficult, and
tie chld  nhlmost chokes,with the effort to swallow, or lets the
dluidi  rcn ou: t the corners of the mouth.  It is uncertain how
lonol this condition may endure; sometimes many days will
pa ssi  duingT' ihiich  death  is hourly expected  and earnestly
prayed for, to put an end to the patient's sufferings.
TSec"'i.~e~. —- In this stage, palliatives only should be used,
such as 3Opiumi  Coniumn,   yosciamus, Cannabis-indica, Chloroform7. E"-her, &c.  In some instances I have applied anodyne
lomien-ations to the head and used anodyne'iihaiations after
the Itittle patient was unable to swallow.




TUiDERICULOUS MENINGITISo               4:
TUBERCULOUS  MENINGITIS,
IN YOUTHS AND A:DULTS.
Dr. KENTNEDY, of Dublin, has seen about 30 cases in the
course of nine years; and thinks that it is more common in
females than males, in the proportion of 2 to 1. Of 80 cases of
tubercular meningitis observed by GUERSENT, 33 were over 15
years of age; and of 12 cases by JACKSON, 7 were adults.  Of
10 cases, 6 were in females, aged 27, 20, 28, 28, 26 and 23 respectively; and 4 in males, aged 22, 20, 21 and 24.
According to IENNED~Y in the majority of cases the disease
commences with the symptoms of a mild, continued or remittent
fever, which goes on without change for 10, 12 or 1]4 days. It
occasionally begins by a distinct complaint of the head, the
patient still being able to go about.
WNhen it conimences with fever, the symptoms are usually
very mild; there is some quickness of the pulse, heat of skin
furred tongue and headache.  The case seems to go on f1-vorably, remedies seem to avail, and the patient may even be pronounced convalescent; or the symptoms may become so slight
that the tongue is scarcely furred, some appetite may be present,
and the patient may sleep well at night.
When the disease commences by fever, the first sign of anything going wrong commonly takes place at night; a marked
increase of fever may then be observed, the tongue becomes
more furred, the skin feverish and the pulse rises to near 100.
KENNEDY has sometimes been led to suspect the serious nature
of the case, by the nurse casually stating that on the previous
night the patient had not slept so well, had talked in her sleep.
or awakened with a scream; these symptoms may return for
four or five nights in succession, and yet the patient seem comparatively -well during the day.
Alterations in the movements or expression of the eye, are
often among the earliest signs, pointing to coming trouble.
Squinting na-y occur, and yet be so slight as to be doubted or
disputed, or it may be intermitting, i. e., present at one moment
and absent the next; or else it only occurs when the patient is
left to herself, but disappearing the moment she is spoken to;




48              TUBERCULOUS MENINGITIS.
these slight changes may occur in one or both eyes, and are
better observed at a little distance. One eyeball may be almost
immovable, and yet it is easy to overlook this; or one pupil
may be somewhat larger than the other; neither are dilated,
but they differ in size. Sometimes the eyelids have a tendency
to droop, and this ptosis may be most marked in one eye.
These eye symptoms are among the most constant and important signs.
At times the first symptom is vomiting, occurring most frequently in the morning; it may happen one or more times, but
never takes the prominent part it does in the hydrocephalus of
childhood.
The head is now more apt to be complained of; perhaps there
may be pain, only when the patient coughs; as a rule it is referred to the forehead over the eyes, but sometimes extends to
the whole head.
This state may continue for four or five days when the sympboms will become more serious; the patient is apt to wander a
little while awake, generally towards evening, but only momentarily, as she is quite herself again when spoken to.  The
countenance is also apt to become heavy, as if she were inclined
to doze.
The next sign which attracts attention is the pulse; in the
course of 24 hours it may fall remarkably, viz.: from 100 or
108 to 60, 55 or even 48. After the lapse of 48 hours more it
begins to rise again, often getting up to 130 or 140, and now the
case progresses rapidly; the patient becomes obtuse, difficult
to rouse. and the signs of confirmed dropsy of the brain are
soon added,
In the advanced stages it is very common to find the patient's
hand applied to the head, and the brows strongly knit, even in
sleep. In some cases the patient will sing the same tune all
night, or may grit her teeth with a degree of violence almost
insupportable.  The entire duration of these cases is about
three weeks; the disease seems to run in families, several members, young and adult being affected; three-fourths of the patients have naturally a heavy aspect; their faces are apt to be
large in proportion to their heads, the lips to be large, and the
skin rather coarse. In fact if a mild remittent fever occur in a




HYDROCEPI-ALOID DISEASE.                49
young person, especially in a girl about fifteen years old, born
of scrofulous or consumptive parents, and slight brain symptoms
show themselves, be upon your guard.
Treatment.-See Tuberculous Meningitis of Children.
HYDROCEPHALOID DISEASE
THIS is a most frequent and often fatal affection, though if
rightly treated it is a very manageable one. It is especially
common in this country, where infantile diarrhoea and summercomplaint occur frequently and severely, and blood-letting and
other reducing treatment are resorted to so commonly, quickly
producing that state of general exhaustion which leads to a train
of symptoms about the head, closely resembling those of dropsy
of the brain. According to WEST, hydrocephaloid disease is
that condition which is induced when the brain is somewhat
suddenly deprived of its usual supply of blood. Even in the
adult a profuse loss of blood is often followed by an extremely
severe headache, and by various other brain-symptoms; while
in the child, whose brain needs a proportionably larger quantity
of blood for the due performance of its functions, the symptoms
that follow its excessive loss are of a corresponding gravity;
often indeed they present a striking similarity to those which
betoken inflammation, or dropsy of the brain.  MARSHALL
HALL even says that in young children, bleeding, purging and
giving calomel enough, in any disease, will bring it on.
Again, there is no disorder in which the two conditions of
considerable sympathetic disturbance of the brain, coupled with
rapid exhaustion of the vital power, are so completely fulfilled
as in infantile diarrhoea, and summer-complaint, and in no other
affections do we meet with such frequent or such well-marked
instances of the supervention of the hydrocephaloid disease.
Symptoms.-This affection may be divided into two stages:
the first, that of irritability; the second, that of torpor. These
two stages resemble in many of their symptoms the first and
second stages of dropsy of the brain.
In the first stage the infant becomes restless, irritable and
feverish; the face is flushed, the surface hot, and the pulse
frequent; there is an undue sensitiveness of the nerves of feelD




50              HYDROCEPIEALOID DISEASE.
ing, and the little patient starts on being touched, or from any
sudden noise; there are sighing and moaning during sleep, and
screaming; the bowels are apt to be flatulent and loose, and the
evacuations are mucous and disordered.-M. HALL.
If the affection arises from the exhaustion caused by diarrhoea,
and if from an erroneous notion as to the nature of this disease,
nourishment and cordials be not given, or if the diarrhoea be
allowed to continue, or be kept up by rmedicines, the exhaustion
which ensues is apt to lead to a different train of symptoms:
The second stage then sets in: the countenance becomes pale,
and the cheeks cool or cold; the eyelids are half closed; the
eyes are fixed, and unattracted by any object placed before
them; the pupils unmoved on the approach of light; the breathing from being quick becomes irregular and sighing; the voice becomes husky, and there is sometimes a husky, teazing cough; and
eventually, if the strength of the little patient continues to decline, there is a rattling in the breathing, and the feet become cold.
Again, according to WEST, under no circumstances are mistakes more easily committed, and never are their results more
mischievous, than when primary and real congestion of the brain
has been somewhat over-treated allopathically, and the consequent symptoms of exhaustion are supposed to be those of advancing disease of the brain. In such a case, however, it would,usually be observed that great faintness had been induced by
the profuse depletion, and that the quiet which succeeded it
was that of exhaustion, as much as of mitigated suffering; the
fontanelle sunk below the level of the bones of the skull, instead of being tense and pulsating; the cool surface,.and the
pulse presenting no other characters than those of frequency
and feebleness, would all point to the real nature of the case.
To deplete further under such circumstances would be to destroy the patient; food is needed, not physic; the sunken powers
of life must be rallied, and as strength returns the functions of
the brain will again go on harmoniously.
The early stages of inflammation of the lungs, are also often
attended with so much sympathetic disturbance of the brain, as'to throw the other symptoms into the back-ground. The child
may vomit, refers all its sufferings to the head, and possibly
-iave an attack of convulsions almost at the onset. The routine




HYDROCEPHALOID DISEASE.                   51
allopathist will naturally assume the case to be one of congestion of the brain, and treat it accordingly with free local depletion; the next day the indications of disordered breathing are
more apparent, and more leeches are applied to the chest. The
urgency of the symptoms may be relieved by these means, or at
least the child may seem to suffer less; but soon the restlessness of exhaustion comes on, and then follow the soporose condition and the apparent coma; if the antiphlogistic treatment is
resumed to arrest this imaginary dropsy of the brain, the little
patient will die.
Treatment. —A  large number of cases of hydrocephaloid
disease are not only caused, but absolutely killed by allopathic treatment, while a proportionately large number will die
under purely homoeopathic treatment: for as WEST truly says,
food and stimulants are required, not medicine. Although the
diagnosis of this affection is sometimes attended with difficulty,
the rules for its prevention and cure are happily very simple.
Bearing in mind the possible supervention of hydrocephaloid
disease, an infant should never be kept from the breast, nor a
young child put upon spare diet for several days without the
most absolute necessity. Especial attention must be paid to
the food of young children, if the disease from which they suffer
be diarrhoea, or some other which interferes directly with their
nutrition; if theechild be'given nothing more nutritious than
barley-water in small quantities, because the irritability of the
stomach which results from weakness, seems to be the indication
of disease in the brain, the restlessness will before long alternate with coma, and the child will die either comatose, or in
convulsions.  The irritability of the stomach is best overcome
by giving nourishment in extremely small quantities, as a
desert-spoonful of ass's milk, or equal parts of milk and barleywater for an infant, or of strong veal tea, for an older child,
given little by little, every half hour. If the exhaustion be
very great, and a state analagous to stupor impending, a hot
mustard bath is sometimes very serviceable in rousing the child,
while, at the same time, a few drops of Spirits of Hartshorn, or
5 to 15 drops of Brandy may be given every few hours.  It is
desirable, however, to suspend the use of the more powerful
direct stimulants as soon as it can safely be done, though a
nutritious diet will be necessary for some time.-WEsT.




52              ATROPHY OF THE BRAIN.
WASTING OF THE BRAIN.-(ATROPHY.)
IN CHILDREN.
SMALLNESS Of the brain sometimes occurs in consequence of
a premature closure of the sutures and fontanelles.  Such cases
are apt to be attended with frequently recurring convulsions;
loss of taste, so that the child cannot distinguish between what
is nice and what is nasty, swallowing all things with the same
readiness; the body and limbs may seem well nourished and
well formed, yet the patient cannot stand or use his limbs properly; the urine and fseces-are apt to be passed involuntarily
and: unconsciously; and gradually every glimmering of understanding will disappear.
Treatment. —-These cases are generally quite hopeless;
Phosphoric-acid in full doses may do some good.
According to WEST those cases are of much higher practical
importance in which the brain of the child wastes or grows
smaller during long-continued ill-health.  The scalp will usually be found pale, thin and bloodless, the fontanelles sunken, and
the process of ossification of the skull unusually tardy; fluid
will be found effused into the sac of the arachnoid and the subjacent pia-mater; the substance of the brain is pale and its
texture firmer than usual.
The important point about such cases is, that brain symptoms and frequently recurring convulsions may be observed in
a child whose brain is not absolutely diseased, but merely too
feeble and too wasted to perform its functions.
Treatment. —In infants who have been exhausted and wasted
by previous illness, the physician must not interpose too hastily
with remedies directed against a supposed brain-disease, but
pursue a tonic and nourishing plan of treatment.  Iodide of
Potash may be used internally and externally to remove the
fluid effused, and may possibly have some effect upon the hardening of the brain, although Plumbumn is the most homceopathic remedy.
Partial atrophy will be marked by symptoms most decided
in particular parts, or on one or the other side of the body.




ENLARGEMENT OF THE BRAIN.                53
IN ADULTS.
According to ROKITANSKY this disease is also common in old
age, and is within certain limits a natural process of shrinking
or decay; it becomes, however, a pathological condition even in
old age, if it proceed to a very great extent, and still more if it
come on prematurely at an early period of life.
The grey substance of the brain is apt to become of a dirty,
or rusty brown color, running into yeast yellow; its consistence
may be natural or distinctly softer than usual.  The white
substance loses its clear color and becomes of a dirty white; it
is denser too than natural, and is sometimes as tough as leather.
The vacuum within the skull, produced by the shrinking of the
brain, is filled up chiefly by a clear colorless serum; the vessels
of the pia-mater become enlarged and varicose.
It leads to congestions of the brain, or Hypercemia ex-vacuo,
causing transient or protracted attacks which simulate apoplexy, and are so frequent in old age; or to actual apoplexy, with
hmemorrhage within the brain; or to cedema of the brain.
Treatnzent.-Iodide of Baryta, Plumbum, and Iodide of Iron
are the principal remedies.
ENLARGEMENT OF THE BRAIN.1
HYPERTROPHY.
ACCORDING to ROKITANSKY enlargement of the brain is
sometimes congenital and is then often combined with dropsy of
the brain; still it more usually comes on after birth, and is
almost exclusively confined to the period of childhood. It is
occasionally met with about the time of puberty, and sometimes,
although exceedingly rarely, even in manhood.
It is the white substance of the brain which is increased
in volume; it is always dazzling white, and remarkably pale
and bloodless, showing that it is not caused by congestion.
When it comes on in childhood, and at puberty, it is combined
with general enlargement of the lymphatic glands and partial
obliteration of the thymus; it is also apt to be attended with
rickets and feeble muscular development.
Its course is generally chronic, but not unfrequently it is




54            ENLARGEMENT OF THE BRAIN.
somewhat acute; the cause of the acute symptoms when they
occur, is a rapid and tumultuous addition to the bulk of the
brain; this only takes place in some instances.
The majority of cases of enlargement of the brain which have
fallen under WEsT's notice in London, occurred in infants about
six or eight months old. Their history has usually been, that
without any definite illness, they had lost their appetite, and
grown by degrees dull and apathetic, though restless and uneasy. Notwithstanding the general apathy, this restlessness
is often very considerable, though it does not show itself in
cries, as much as in a state of general uneasiness, and in frequent startings from sleep.  Short gleams of cheerfulness occur
when the children are awake, but these are usually very transient. The head seems too heavy to be borne, and even when
its size is not much greater than natural, it hangs backwards,
or to one side, as if the muscles were too weak to support it.
If placed in its cot, a child who is thus affected, bores with its
occiput in the pillow, while its head is almost constantly in a
profuse perspiration.  Convulsions sometimes occur without any
evident cause, but threatenings of their attack are much more
frequent than their actual occurrence, the child awaking suddenly with a start, and a peculiar cry, like that of spasmodic
croup, the surface turning livid, and the respiration becoming
difficult for a few mnoments, and the symptoms then subsiding of
their own accord.  Such attacks may issue in general convulsions, which may terminate fatally; but infants thus affected
do not by any means invariably die of the cerebral disorder,
but, being weakly, they are often cut off by the first malady
that attacks them.
If life be prolonged the child loses flesh, and looks out of
health, while enlargement of the wrists and ankles, shows the
connection between this disease and rickets; a connection which
becomes more evident in the second and third years of life.
W~hen the child survives infancy, or when as occasionally happens the symptoms of enlargement of the brain do not come on
until dentition has been in a great measure accomplished, convulsions are of very rare occurrence.  Complaints of headache,
however, are frequent and severe; and, though drowsy in the
daytime the child generally rests ill at night, and often awakes




ENLARGEMENT OF THE BRAIN.                 55
crying and alarmed. Besides these symptoms, too, the child
has occasional attacks of feverishness, with great increase of
headache and giddiness, which last for a few hours or a day,
and then subside of their own accord, while it grows by degrees
more and more dull and listless, and its mental powers become
obviously impaired.
It happens in some cases, that, as the child grows older,
these symptoms become less and less severe, the health improves, the ricketty deformity of the limbs gradually disappears and the infant who had excited so much solicitude becomes at length a healthy child.
Chronic dropsy of the brain is the only affection with which
enlargement of the brain is liable to be confounded.  The
diagnosis between the two affections is often by no means
easy, though it is of much importance with reference to the
treatment.
The symptoms of chronic dropsy of the brain generally come
on earlier, and soon grow much more serious than those of enlargement of the brain, and the disturbance of the brain is
throughout much more marked in chronic hydrocephalus than
in hypertrophy.  Convulsions, sopor and restlessness attend
the early stages of chronic hydrocephalus, while spasmodic
affections of the respiration are among the earliest indications
of enlargement of the brain.
The form and size of the' head, too, present peculiarities by
which we may often distinguish between the twio conditions;
both diseases are attended with enlargement of the head, and
in both the ossification of the skull is very tardy, but the head
does not attain so large a size in hypertrophy of the brain,
neither are the fontanelles and sutures so widely open.
The skull also presents some remarklable peculiarities; the
head not only shows no tendency to assume the rounded form
characteristic of chronic hydrocephalus, but its enlargement is
first apparent at the occiput, and the bulgingo of the hind-head
continues especially striking.
The forehead may, in the course of time become prominent
and overhanging) but the eye remains deep sunk in its socket,
for no change takes place in the direction of the orbitar plates,
such as is produced by the pressure of fluid within the brain,




56            ENLARGEMENT OF THE BRAIN.
and which gives to the eye that unnatural prominence, and that
peculiar downward direction which are so striking in cases of
chronic hydrocephalus.
In chronic dropsy of the brain the anterior fontanelle is tense
and prominent, owing to the pressure of the fluid within, but
when the brain is enlarged, there is no prominence but an
actual depression in this situation. WEST has more than once
observed this condition in a remarkable degree, the depression
not being limited to the anterior fontanelle, but being also observable at all the sutures.
When enlargement of the brain occurs in the adult, the symptoms that arise are in a great measure due to the compression
which the organ undergoes from its bony case being too small
to contain it. The symptoms are of course exceedingly obscure.
-MAUTHNER and WEST.
Treatment.-Vinum-ferri, Ferro-citrate of Quinine, Iodides
of Iron and Potash and Cod-liver Oil, have been used most frequently and successfully.  Agaricus, Calc.-phos., Kali-carb.,
Mezereum and Rhododendron are the principal homoeopathic
remedies.
D~aphne-indica is suitable when there is a sensation as if the
outer part of the brain were inflamed and striking against the
skull.
Sulphur, Staphysag-ria and Stannum when there is pain
as if the brain were beating against the skull, or a painful
pressing of the brain against the skull and occipital bones, in
the evening, even after going to bed.
Chelidoniul~n when there is a pressing in the brain, as if the
skull were too narrow, and the brain would be pressed out of
the eyes, nose or ears.
Baryta and Conziun when the head seems too full as if it
would burst; especially in both frontal eminences and in the
orbits.




HYDROCEPHALUS.                      57
Y D R O CE  PI A LU S.
DROPSY OF THE BRAIN.
IN by far the greater number of cases the fluid collects in
the interior of the brain, constituting what is called internal
hydrocephalus in contra-distinction to other cases in which the
fluid is contained in the sac of the arachnoid, and to which the
name of external hydrocephalus has been given.
INTERNAL EIYDROCEPHALUS.
The internal membrane of the ventricles of the brain is
composed of a very delicate continuation of the arachnoid and
pia-mater, and a layer of epithelium.  The most frequent and
imnportant diseases to which it is liable, have, from one most
striking characteristic which they present, viz.: an excessive
accumulation of fluid, been included together under the title of
hydrocephalus.
The disease may be acute or chronic, inflanmmatory, or noninflammatory.
In the acute inflammatory form, a turbid fluid is found in
the ventricles, composed of serum and lymph or pus; the lining
membrane of the ventricles becomes dull, opaque, softened and
even diffluent, so that shreds of it often appear in the inflammatory effusion in the ventricles.
The substance of the brain is in a state of acute oedema, and
infiltrated to such a degree that it seems as if it were in a state
of watery softening; hence the brain itself is swollen and actually increased in volume, so that its convolutions are forced
against the skull and flattened.
It is very apt to be associated with tubercular meningitis. —
RIOKITANSKY.
In the acute non-inflamzmatory fornm, a clear, colorless, serous fluid, varying in quantity from one or two to six ounces, is
found in the ventricles. Although the disease is often acute, it
cannot be admitted to be inflammatory; it arises from congestions of various kinds, viz.: such as are connected with the
development of the brain in childhood, or those produced by
chronic eruptions on the scalp, by the irritation of morbid




58                   HYDROCEPHALUS.
growths within the skull, &c.; or it may be occasioned, too, by
the congestions which follow concussion of the brain, or mechanical obstructions of the heart, chronic catarrh of the lungs, or
bronchi, &c., &c. The result of these congestions is an excessive effusion of serum, first from the lining membrane of the
ventricles, and then into the brain itself.  It is frequently
associated with enlargement of the whole system of lymphatic
glands, and of the follicular apparatus of the intestinal mucous
membrane; with enlargement of the thymus gland, with chronic
catarrh of the bronchi, and with rickets.-ROKIITANSKY.
CHRONIC HYDROCEPHALUS.
According to ROKITANSKv this disease may be divided into
three varieties, viz.: 1st, into congenital hydrocephalus; 2d,
that which commences at various periods after birth, but generally during the first six months; and 3d, hydrocephalus occasioned by a vacuum  within the skull, from atrophy of the
brain.
According to WEST, in the majority of cases the disease is
not a mere passive dropsy, but is the consequence of a slow
kind of inflammation of the arachnoid, especially of that lining
the ventricles, which may have existed during fetal life, or not
have attacked the child until after its birth.
In 50 cases collected by WEST, some symptoms of it were
observed in 46 instances before the child was six months old;
in 12 of these the disease was congenital; and in 19 more, the
malady was established before the child was three months old.
Symptoms.-The early symptoms vary; when it is congenital, indications of disturbance of the brain are generally apparent from the infant's birth; these are sometimes serious, such
as convulsions, recurring almost daily; or slight, consisting of
ihothing more than squinting, or strange rolling of the eyes.
The size of the head generally attracts attention before long,
and causes importance to be attached to symptoms which otherwise might have given rise to but little anxiety. In some instances, however, the increased size of the head is not very
obvious until the child is a few weeks old, although well-marked
symptoms of mischief in the brain existed from its birth; en



HEYDROCEPHALUS.                     59
largement of the head, in fact, is by no means invariably the
first indication of chronic hydrocephalus.  According to WEST
in 12 cases out of 45, fits returning frequently, had existed
for some weeks before the head was observed to increase in
size; in 6 instances the enlargement of the head succeeded to
an attack resembling acute dropsy of the brain; and in 4
other examples, it had been preceded by some well-marked indications of mischief in the brain; in the remaining 23 cases,
out of 50, no distinct brain-symptoms preceded the enlargement
of the head.
In whatever way the disease begins, the child's health will
have been noticed to be failing for some time, although the
cause of its illness may not be apparent; impairment of the
processes of nutrition is sure to be among its earliest symptoms.
The child may nurse or feed well, and indeed may seem eager
for food, but still it loses both flesh and strength; and often,
although the head has not yet attained any disproportionate
size, the child is unable to support it, either losing the power
it had once possessed, or never attaining that which, with its
increasing age it ought to acquire; the bowels are generally
constipated, but diarrhoea often comes on for a day or two, and
the evacuations are almost always unhealthy.  In short, in the
primary symptoms there is but little to distinguish the case
from any other in which a young infant is imperfectly nourished;
even, although occasional attacks of heat of head may be observed, attended with pulsation or tension of the anterior fontanelle, attended with crying and restlessness, alternating with a
drowsy condition by day and restless nights,-still these symptoms occur frequently enough from transient causes: they
acquire a more marked significance, if coupled with an unusually
open state of the fontanelles and sutures, even if no marked
enlargement of the head be yet perceptible.
By and by, however, the increased. size of the head grows
very manifest, and the child's physiognomy soon assumes the
distinguishing features of chronic hydrocephalus; the sutures
become wider, the fontanelles increase in size, and the head
assumes a globular shape. [But the greatest increase in the
size of the head is effected by the enlargement of the anterior
fontanelle, and by the widening of the sagittal suture.  The




60                   HYDROCEPHALUS.
forehead is projected forwards; the orbitar plates of the frontal
bone are driven by the accumulating fluid from a horizontal into
an oblique direction, and sometimes indeed they become nearly
perpendicular, when by contracting the orbits they give to the
eyeballs that unnatural prominence and that peculiar downward
direction which constitutes one of the most remarkable features
in cases of chronic hydrocephalus. In hypertrophy of the brain
the back of the head is much larger than the front.-WEST.
The symptoms of disturbance of the brain that attend the
advance of the disease differ much in severity; sometimes there
is little but uneasiness and restlessness, aggravated at intervals
when the head grows hot and the fontanelle grows tense; in
other cases, convulsions occur frequently, from very slight, or
no evident causes; in another set of cases, spasmodic attacks of
difficult breathing, attended with a crowing sound in inspiration
are apt to occur, even before there is much enlargement of the
head. —WEsT.
Treatment.-WAHLE says that lHellebor.-nig., Arsenicum
and Sulphur are the principal remedies; he has often effected
radical cures even in congenital hydrocephalus.  I-Ie always
commenced the treatment with Hellebore, and persisted in its
use for eight or ten days. Against the spasms, Sulphur 30,
was the most efficient remedy, all other seemingly appropriate
remedies were useless. Aconite 80, was most useful against
mental disturbances.
The treatment of G6LIS of Vienna, was to have the head
shaved, or hair cut close, and one or two cirachms of the mild
mercurial ointment rubbed daily into the scalp; the head to be
constantly covered with a flannel cap, and, or i grain of calomel to be given twice daily, unless diarrhoea comes on. This
plan requires perseverance for thirty to forty days. Hydriodate of Potash is safer and perhaps more efficient.
Methodical compression of the head with strips of adhesive
plaster has been used successfully; and 18 cases out of 63, or
2 cases out of 7 are said to have been radically cured by puncture of the cranium and evacuation of the fluid.
CASE 1.-A rhachitic child, aged 3 years, had swollen
joints, was unable to walk, even when supported, and finally
became affected with full developed chronic hydrocephalus; the




HYDROCEPHALUS.                     61
sutures were widely separated; the child lay upon its back,
covered with a sticky perspiration, it had constant fever, grasped
at its head, became unconscious and passed its evacuations involuntarily.
Treatment. —Calc.-c. 30, one dose every week; in five weeks
the dropsy of the head seemed removed and the enlargement
of the joints lessened. By the continued use of Cale. the child
gradually recovered perfectly. —IvANovIca.
CASE 2. —A boy, aged 14 months, was attacked with inflammation of the brain which terminated in dropsy; spasmodic
and paralytic affections ensued, and finally the child lay unconscious with all the usual signs of hydrocephalus.
Trealtnent. —The patient was entirely restored in the course
of ten weeks by Bell., Bryon., Mere., Hell., IHyosc. and Sulph.
-MAL Y.
CASE 3.-A boy, aged 1 year, had a very large and heavy
head; with widely open fontanelles; the eyes projected over the
edge of the orbits; there was strabismus; almost entire absence of all human expression; the child only made grunting
and beastly sounds; the skin hung loose upon the emaciated
hands and feet; the abdomen was much bloated; there was offensive diarrhea intermixed with hard masses of fseces; involuntary discharge of urine and fseces; spasms and opisthotonos;
canine appetite.
Treatment and Result.-From  Jan. 6 to Nov. 18, the child
received Calc. 200 and Sulph. 200, in alternation every ten or
fourteen days, with constant improvement; the spasms lessened,
the teeth came through, the eyes retreated into their sockets,
the expression became human and pleasant, it improved in body
and began to walk and speak.-BREDENOLL.
CASE 4.-A boy aged 3 vears, had already suffered for two
years with signs of hydrocephalus; his head was large, and
inclined to fall forwards; the fontanelles were very large, the
forehead projecting, the eyes sunken, the pupils dilated, face
earthy and bloated; there was constant dribbling of water from
the mouth; the teeth were small and imperfect; the limbs weak
and unable to support the body; greedy desire for food.




62                   HYDROCEPHALUS.
Treatizent.-Five doses of Bellad. 30, X drop doses, were
given in the course of sixteen days, with evident signs of improvement. A feverish attack with aggravation of all the symptoms, was then relieved by Acon., followed by 2 doses of Bellad.,
without further benefit to the principal disease; hence 9 doses
of Merc.-viv. 6, were given, 1 close every three or four days,
with remarkable relief from all the symptoms. The paralytic
weakness of the limbs was removed by 2 doses of Phosph. 30
and China 6.  Finally the child was perfectly restored.SCHWARZ.
CASE  5. —A boy, aged 3 years, was attacked with dropsy
of the head. Bellad., Hepar. and Conium diminished the great
size of the head.
Sometime after he fell in the water, after which he could no
longer stand upon his feet, nor move himself; nor speak, or eat;
while drinking he pressed his tongue against the hard palate,
so that one-half of the fluid ran out of the mouth again.
Treatment.-Hyosc. 18, 1 dose every night and morning removed this state in three days. —HARTUNG.
REVIEW. —Calcarea was used in 2 cases, in the 30th and
300th potencies; the latter in alternation with Sulphur.
Belladonna effected most in case 4, but was also useful in
cases 2 and 5.
WAHLE calls particular attention to Hellebore, Sulphur and
Arsenicum.
lIercurius was very useful in case 4.
The general paralytic state in case 5, was evidently in close
connection with the previous state of the brain and was soon
cured by Hyosciamus.
EXTERNAL HYDROCEPHALUS.
In this disease according to HowsHIP the patient seems
always disposed to doze, yet its senses are awake to the lightest
and least impression; the peculiar symptom is that of being at
one and the same time light-headed, yet perfectly sensible; the
patient speaking incoherently to himself, yet if spoken to answering clearly and rationally.  This peculiar state is supposed
to occur only when there is an abundant serous effusion between
the membranes, and none in the ventricles of the brain.




HYDROCEPHALUS.                      63
Treatment of Hydrocephalus.-Aconite is supposed to be
homceopathic to congestion of the brain only.
Aethsca-cynaplium to congestion of the brain and its sinuses.
Ammonizzm-nzur. is homceopathic to atrophy and collapse of
the brain.
Arsenicun, to inflammation of the membranes and substance
of the brain, serous effusion into the ventricles.
Belladonna, to excessive congestion of the brain.
Bismuth, to serous effusion, here and there between the convolutions of the brain, and in the ventricles.
Bronmine, to venous congestion and considerable redness of
the pia-mater.
Bruccea-antidysenterica, to great congestion of the left hemisphere of the brain and cerebellum, with effusion of a considerable quantity of serum into the ventricles.
Camphor, to violent congestion and inflanmmnation of the
membranes and substance of the brain, with softening.
Cannabis-sativa, to congestion and extravasation upon the
arachnoid, clear serous effusion in the convolutions of the brain,
throughout and into the lateral ventricles, with some softening
of the brain.
Cantharides, to congestion of the brain, particularly of the
cerebellum, which is covered with a thick layer of exuded
lymph, attended with an effusion of a quantity of serum at the
base of the skull.
Chininzum-sulphuricum, to congestion of the brain and spinal marrow, red and white softening of the nedullary substance,
with effusion of serum.
Cicuta-virosa, against meningeal apoplexy, induration of the
brain, serous effusion in one of the ventricles, and dark red fluid
at the base of the skull.
Colocynth, against congestion of the surface of the brain, and
inflammation of the pia-mater.
Conium, when there is a considerable quantity of water in
the ventricles of the brain.
Digitalis, when the membranes of the brain are strongly injected.
Gratiola, when there is a fiery-red injection of the pia-mater.
Helleborus, when there is no fluid in the ventricles of the




64                   HYDROCEPHALUS.
brain, but the superficial veins are filled with black blood, and
the pia-mater is considerably injected, the brain being softened
and withering, or atrophied.
Hydrocyanic-acid, when the brain and its membranes are
congested, with extravasation of blood, (true apoplexy,) with effusion of serum at the base of the skull; congestion of the walls
of the ventricles.
Hyoscialzts, when the brain is congested and the ventricles
empty.
Laurocerasus, when the upper surface of the brain is congested, and also the inner vessels of the ventricles.
N2ux-vonzica, softening of the brain and spinal marrow, congestion of the cortical substance and pons varolii.
Oleander, when the ventricles of the brain contain a small
quantity of reddish fluid, and the superficial vessels of the brain
are tinged with blood.
O Fizlm, when there is congestion and extravasation of blood, in
and upon the brain; softening of the brain so that it was almost
impossible to distinguish the medullary from the cortical substance; extravasation of serum at the base of the brain and in
the ventricles.
Oxalic-acid, when there is effusion under the arachnoid.
Phosphorus, when there is a wide-spread and thick accumulation of yellowish-white, opalescent exudation (plastic lymph,)
between the pia-mater and arachnoid, by means of which these
two membranes are glued together, (meningitis).
Plumbumn, when there is a considerable flatness (atrophy) of
the convolutions of the brain, with paleness and softness of the
parenchyma, brown clear serum in the middle ventricle, unusual
softness or hardness of the substance of the brain, with clear
serum at the base of the skull.
Secale, when the vessels of the brain are empty.




ACUTE AND GENERAL INFLAMMATION OF THE BRAIN. 65
ACUTE AND GENERAL INFLAMMATION OF THE  BRAIN.
IN ADULTS.
According to WATSON, acute inflammation does sometimes
appear to invade at once the whole of the parts that are lodged
within the skull, or, beginning in one part, it extends rapidly to
all the rest. This disease as it occurs in adults presents two
periods, which are marked by different symptoms, and are in
most instances distinctly observable. In the first period, what
are called symptoms of excitement predominate; in the second
period those symptoms appear which are comprised under the
term collapse. Sometimes these two periods instead of following each other are more or less mixed and confounded. But
the distinction is real and requires to be attended to. —WATSON.
Period of excitement.-The symptoms are pain in the head,
often intense and deeply seated, or extending over a large part
of it; a sense of constriction across the forehead; throbbing of
the temporal arteries; flushing of the face; injection of the
eyes, which have a wild and brilliant look; contraction of the
pupils; unusual sensitiveness to external impressions, amounting frequently to impatience of light and sound; violent delirium;
want of sleep; paroxysms of general convulsions; a parched
and dry skin; a frequent and hard pulse; white tongue;
thirst; nausea and vomiting; constipation.
lWodes in which the disease coimmences.-The attack may
come on in three or four different ways:
1st. Sometimes there is a sudden alteration of manner, and
the patient, complaining probably of his head, becomes all at
once and furiously delirious; fever is also lighted up.
2d. In other cases the first thing noticed is nausea and vomiting, which may soon cease, or continue for several days, or even
throughout the whole course of the disease. Great quantities
of yellow, bitter, bilious fluid are brought up, and whatever is
introduced into the stomach, even a small quantity of the most
simple drink is immediately rejected. With this state of matters there is generally much constipation, and the bowels refuse
to act except under the influence of strong purgatives. It is
E




66 ACUTE AND GENERAL INFLAMMATION OF THE BRAIN.
very easy to mistake these cases for attacks of sick-headache,
bilious derangement, &c., &c.-WATSON.
3d. Another set of cases of acute inflammation of the brain,
commences with paroxysms of general convulsions, such as often
usher in an attack of meningitis. This symptom according to
ANDRAL is a much more certain sign of inflammation of the
brain, than the occurrence of active delirium, and WATSON
quite agrees with him in so thinking.
WATSON supposes that the cases which are characterized by
early and fierce delirium are cases in which the inflammatory
action has invaded the whole of the brain and its membranes
simultaneously. It is lmore probable that a large portion of the
grey substance of the brain is principally inflamed. He also
assumes that when nausea and vomiting are the earliest symptoms, the inflammation has taken its point of departure in the
cerebral pulp; in the substance of the brain. The seat of the
disease is, however, doubtless in the corpora-quadrigemina and
striata, (see Treatise on Headaches, p. xiv.)   Finally, he
guesses that when the attack comes on with a sudden fit of
convulsion, the inflammation has commenced in the pia-mater or
arachnoid. It is more apt to be located in the white substance
of the brain.
Simple inflammation of the brain proper, without any simultaneous affection of the membranes, has been fully considered
in the chapter on red or inflammatory softening of the brain,
(see Treatise on Apoplexy, p. 143.)
Period of collapse.-The first or acute stage lasts for a variable period, i. e. from one-half to two days or more, and then it
is succeeded by the second stage, or that of collapse.  The
patient then ceases to complain of headache; instead of being
excited or wildly delirious, he mutters indistinctly, and falls
into a state of stupor, from which it is difficult, and at length
impossible to arouse him. His vision and hearing are no longer
painfully acute; squinting and double vision are not uncommon;
and the pupil, from having been contracted to the size of a pin's
point, becomes first oscillating, then widely dilated, and ultimately motionless. Twitchings of the muscles and startings
of the tendons take the place of convulsions, although some of
the limbs may be agitated with tremors, or become powerless




ABSCESS OF THE BRAIN.                   67
and palsied. The face becomes ghastly and cadaverous; cold
sweats break out; the sphincters relax; finally the coma becomes profound and life ceases.-WATso N.
Treatment.-In this disease, which is too often fatal under
any mode of treatment, a mere symptomatic homeopathic procedure is ruinous. If too much attention be paid to the management of the delirium, convulsions or vomitings, the inflammation will progress rapidly and unchecked. Aconite should
be used freely, internally and externally; if this fails Veratrurm-viride may be used.  In some cases Opium  and Aconite
should be given in alternation.  As soon as exudation takes
place, Mercurius, Hydriodate of Potash and Phosphor. are the
principal remedies.
ABSCESS  OF  THIE  BRAIN.
According to VALLEIX it is much more rare to find a perfectly circumscribed abscess than a diffuse softening with suppuration.
The causes of this affection are very similar to those of inflammatory softening, such as external violence in young and
vigorous subjects, absorption of pus in consequence of operations
on distant parts, and especially from the suppression of chronic
discharges from the ear.
Symnptoms.-The most important one is headache, the pain
of which is acute, persistent, and causes constant complaints
from the patient, who almost always presses his head with his
hand, contracts his brows, and assumes the strangest positions
in the hope of escaping his agony.  After the disease has
lasted a certain length of time the pain subsides and even disappears.
The intelligence may be disordered in various ways; sometimes there is an active, more frequently a quiet delirium; at
other times there is a marked dulness of the intellect, and the
patient has an obtuse manner, does not answer questions, but
continues to complain of his head. This hebitude generally follows after previous delirium and agitation.
On the motor side, we may observe convulsions, epileptiform
attacks, or rigidity; or there may be paralysis more or less




68              HYDATIDS IN THE BRAIN.
complete, or merely a weakness and sluggishness of every movement, similar to the hebetude of the brain. The paralysis does
not ordinarily set in suddenly, but sometimes it succeeds soon
after the convulsions. The sensibility is not always diminished
unless there is simultaneous paralysis.
Sometimes there is fever, with heat of skin, acceleration of
pulse, redness of the face, &c.; in other cases there is none.
Vomiting and constipation are far from being constantly
present; the respiration is not apt to be affected.
It is supposed that the symptoms of abscess of the brain
from external violence are the most decided and acute, and that
paralysis promptly follows the agitation and delirium. Abscess
from disease of the bones of the skull, has less severe and urgent symptoms; while that which arises from suppression of a
discharge from the ear, follows a slow and insidious course, with
but few prominent symptoms.
When the abscess is seated in the grey substance of the convolutions, the delirium and agitation are the most marked symptoms; when it is located in the grey portions of the interior
of the brain, rigidity of the limbs and convulsions are the
most prominent symptoms; paralysis is most common when the
disease is in the white substance; general paralysis occurs
when the collection of pus is in the annular protuberance;
when the abscess is in one hemisphere of the brain or cerebellum, the paralysis will be on the opposite side.-VALLEIX.
Treatment.-The truly homoeopathic remedies against suppurative inflammation are Tartar-emetic, Cantharides, Rhus,
Sabina and Phosphor. The solvents of the pus globules are:
Kali-carb. and Baryta-muriatica.
HYDATIDS IN THE BRAIN.
There are several varieties:
1st. The hydatids spuria is merely a hydropic primordial
cell; it is more frequently met with than the other varieties
and may be found in almost every part of the brain.
Symptoms.-The pain in the head they cause is constant;
in true hydatids it is intermittent. They are apt to be attended with loss of sensation, dulness of intellect and loss of
memory.




HYDATIDS IN THE BRAIN.                   69
2d. Acephalocysts, are very rare; of 21 specimens presented
to KLENCKE for examination, only 3 were genuine; they are
generally of the size of a lentil or pea, of an opaline color, and
contain a mass of microscopic cells.
Symnptoms.-These vary much; generally there is headache,
but not more severe than in some other diseases.
If they are developed in the pons, fornix, crura-cerebri, hemispheres of the cerebellum, or base of the medulla-oblongata, or
if they compress these structures, they induce peculiar affections
of the muscular system, ending ultimately in epilepsy.
When confined to the cerebral hemispheres they cause stupor
only, or headache, or in extreme cases, apoplexy.
If the acephalocysts be numerous, the respiration is apt to
be slew; if they are seated in the corpus callosum the pulse
is generally slow; if in the pes-hippocampi the pulse may be
quickened.
If seated in the thalami-optici and crura-cerebri, they are apt
to be attended with hallucinations, flashes of light before the
eyes, or blindness.
If in the corpora-striata, or quadrigenema, we are apt to find
spasms of the stomach, spasmodic colic, or paralysis of the colon.
If the cerebellum be implicated, there generally is paralysis
of the bowels or bladder, with abolition of the sexual functions.
3d. The presence of polycephalus causes the rotary disease
in sheep. In man it causes headache, rotation, loss of memory,
and insensibility to light.
4th. The cysticeruts, and also the polycephalus are apt to
cause periodic headaches, owing to the greater or less active
movements of the parasites; every motion of the neck, or the
crown of hooks arround it causes irritation of the brain.
Treatment.-M any of the symptoms produced by these parasites are relieved in a remarkable manner by brandy, for alcohol acts as a poison, especially upon the cysterceri and converts
them into a torpid mass.
Nitrate of silver has relieved many of the gastric affections,
also the trembling of the hands and convulsive action of the
eyelids, &c.
Nux-vomica and Secale are supposed to exert a beneficial
action upon them.




70              TUBERCLES OF THE BRAIN.
TUBERCLES  OF  THE  BRAIN.
Under this head we do not refer to cases in which tubercle is
present merely in the membranes of the brain, producing that
granular appearance which has been alluded to when treating of
tubercular meningitis, but to separate and independent deposits
of tubercular matter into the substance of the brain itself.
Tubercles of the brain though exceedingly rare in the adult,
are not very uncommon in the child: thus, while Louis met
with only 1 case of tubercle in the brains of 117 adults who
died of tubercular disease, RILLIET and BARTHEZ found it 37
times in 312 cases of fatal tubercular disease in children.
WEST knows of no instance in which tubercle was limited to
the brain in childhood, for if present there it always existed in
other viscera, especially in the bronchial glands and lungs,
shewing that it is but one of the results of that general
cachexia which may show itself in any of the various forms
of scrofulous or consumptive disease. This fact is very important in forming an opinion as to the nature of various local
diseases of the brain; for softening of the brain, or abscess, or
tubercles, hydatids or cancer, do not disclose their precise nature by any peculiar symptoms, or succession of symptoms.
They all, sooner or later disturb the functions of the brain, and
they may all disturb them very nearly after the same fashion.
But we may judge sometimes, from other circumstances, that
the disease is of this or that character; thus, if we find scrofuious or cancerous disease in other parts of the body, we may
safely infer that the symptoms which denote disease of the
brain, are caused by scrofulous or cancerous tumors there
situated; but from  the symptoms themselves, we can only
learn that there is some morbid condition of the brain. -WATSON.
According to ROKITANSKY the number of tubercles in the
brain is usually small; one or two being met with in most
cases, and more rarely, three, four, five or a few more; some
extremely rare exceptions do occur in which twenty or more are
found. When they are but few, each separate tubercle acquires
a considerable size, the most usual size is that of a hazel or




TUBERCLES OF THE BRAIN.                 71
walnut; when they are more numerous, no single one often is
found much larger than a hemp-seed or pea, although I have
seen at least twenty in one child's brain, and none less than a
hazel-nut in size. Tubercles of the brain are also peculiar in
not being generally aggregated together, but separated widely
apart.
Every part of the brain is occasionally the seat of tubercle.
They are very common in the brain itself, and less so in the
cerebellum; they are rarely found in the pons, and still less so
in the medulla-0blongata.  As a general rule they are deposited
in or near the grey substance, hence near the surface of the
brain, or in the grey portions of the corpora striata or optic
thalami. The corpus callosum, fornix, septum lucidum, and
crura scarcely ever contain any.-RoKITANSKY.
Its most frequent combination is with tuberculosis of the absorbent glands; and next in frequency with tubercle in the
lungs.
When seated near the surface of the brain, they may cause
tuberculous inflammation of the membranes, and acute dropsy
of the brain.
Synnptoms. —These vary according to the number and location of the tubercles, and to the existence or non-existence of
softening of the brain around them.
In one case, in a boy aged 3} years, and in the left hemisphere of whose cerebellum WEST found a tubercle, there had
been an almost constant and involuntary rotary motion of the
head when lying down; but this is a rare symptom.
As they are generally seated near the surface of the brain,
we would expect often to find delirium, stupor, or headache. In
fact IHENNIS GREEN mentions pain in the head as the most
constant symptom of the early stages of the disease, having met
with it as a prominent symptom in 17 cases out of 20. This
pain is often very severe, so that during its continuance the
child shrieks with the agony of the suffering; but singularly
enough it does not continue with this intensity for more than a
few hours, and on the next day the child may be found to be no
worse than usual. Vomiting in many instances attends these
exacerbations of pain.
In other instances a general dulness steals over all the facul



72              TUBERCLES OF THE BRAIN.
ties, and the child grows quite indifferent to what is going on
around it; he may never complain of headache, but be fretful
and cry if moved, yet be perfectly quiet if allowed to remain
undisturbed, dozing for hours together.
According to GENDRIN when the tubercles are located in one
cerebral peduncle, convulsions commence in one leg and from
thence extend to the whole of the same side on which the peduncle is affected.
When they occupy the mesocephalon, the muscles of the face
and especially of the mouth are most convulsed, and generally
spasms only occur at a later period.
In a very few cases no symptoms are present; much more
frequently, however, the signs of disturbance of the brain,
though not entirely absent, are too vague to excite much attention and too slight to occasion much suffering, so that if they do
not wholly escape notice, they are confounded with other indications of ill-health attendant upon the general tubercularization
with which this disease of the brain is frequently associated.
In these latent, or semi-latent cases death finally takes place
rather suddenly, under the indications of the most serious braindisease. This acute stage sometimes lasts for a few hours only,
and a child who had shown no sign of head-affection, though
probably the symptoms of tubercular disease of the lungs or other
organs had long been present, suddenly sinks into a state of stupor, which soon deepens into a profound and fatal coma. In another set of cases convulsions take place suddenly, followed by paralysis of one limb, or of the whole of one side, and either is
immediately succeeded by coma, or this does not come on till
after the fits have recurred several times. In a third variety
of cases death is preceded by symptoms of acute dropsy of the
brain.  This sudden outbreak of symptoms may take place
without evident cause, or follow a not very severe blow or fall
upon the head.-WEsT.
When headache, nausea and vomiting are present, the case
may still be obscure; for some delicate children have irregular
attacks of violent headache, off and on for years, accompanied
with vomiting, from slight causes or no apparent cause at all,
and finally recover as their health becomes more robust.  Some
children may even have headache aggravated at intervals and




TUBERCLES OF THE BRAIN.                 73
associated with occasional convulsive movements of one limb,
and even with attacks of an epileptic character, and yet show
by the confirmed health they subsequently attain to, that some
cause of a less abiding nature than a tubercular deposit must
have given rise to the disturbance of the brain.-WEST.
Affections of the motor system are, however, often among the
earliest indications of this disease; convulsive movements are
the most frequent of these; paralysis of a limb, or impaired
power over it, usually succeeds the convulsions, and but seldom
take place independently of them.  Sometimes we observe
nothing more than an occasional convulsive twitching of one
limb, more frequently of the arm than of the leg, unattended
with any loss of consciousness, or impairment of the intellect;
but the seizure is more frequently attended with stupor, though
the convulsive action may be confined to one side; or even to
one limb. When convulsions, whether general or partial, have
once occurred they are seldom absent for many days together.
The transition from the premonitory to the acute stage sometimes takes place gradually, the convulsions becoming more and
more frequent, and the other brain symptoms more serious, and
the intervals of freedom from suffering shorter; or the change
takes place suddenly, and without such previous increase in the
severity of the child's suffering as to make one anticipate its
approaching death; and yet we cannot always discover such
differences between the morbid appearances in the two cases as
should explain the dissimilar course of the disease.-WEsT.
When tubercles are seated solely in the corpus-striatum,
there will probably be convulsive movements when a portion
only is involved, and paralysis if the disease includes the whole
of the organ.
If located in the optic thalami, there will be more or less loss
of sensation.
Tubercular disease of the medulla-oblongata and pons-varolii,
is attended with difficulty and irregularity of breathing.
Disease of the crus-cerebri is followed by convulsions or
paralysis of the opposite side; also when the white substance
of the brain is involved. The symptoms of tuberculosis of other
parts of the brain will be similar to those which have been observed when hydatids are present.




74              TUBERCLES OF THE BRAIN.
Treatment. —The infants of tuberculous mothers should be
weaned early, or given to a healthy wet-nurse, or what perhaps
would be better still, they should be fed upon diluted cream; as
milk, both human and animal, contains a large proportion of
albumen and caseine, it should be entirely avoided. Milk. as is
well-known, is a watery liquid, having in solution a certain
amount of caseine, sugar of milk or lactirne, extractive matter,
together with several inorganic salts, (such as the Phosphates
of Lime, Magnesia, and of the Per-oxide of Iron, the Chlorides
of Potassium and Sodium, and Pure-soda,) and holding in suspension myriads of extremely minute globules of fatty matter,
plainly visible through the microscope. Fresh milk is almost
invariably slightly alkaline, but on exposure to air, especially
in warm weather, it rapidly becomes acid, owing to the conversion of the sugar of milk or lactine, into lactic acid, under the
influence of the caseine which acts as a ferment. If the milk
has been long retained in the breast, this change occasionally
takes place before being drawn; and in some morbid conditions
also, the milk is found to have an acid reaction even when freshly drawn. Such milk would be especially injurious to children
with a tendency to tuberculous ailments; if milk be used at all,
the mother should be supplied with litimus paper to test each
specimen before it is given to the babe.
Acidity of the stomach and bowels should be carefully obviated and prevented; still ordinary acidity of the digestive organs
will not necessarily produce tuberculous disease. As the Chlorides and Phosphates of Soda and Potassa are deficient in tuberculous blood, it might be advisable to use these salts to correct
or prevent acidity of the stomach and bowels.
As Iron is decidedly deficient in the blood of tuberculous
subjects I have long been in the habit of using a combination
of equal parts of Phosphate of Iron and Phosphate of Lime or
Soda, thoroughly triturated together, and mixed with double its
weight of Sugar, in order to prevent acidity of the stomach, and
supply the requisite quantity of Iron to the system.  Phosphate of Lime ought also be an excellent dietetic and preventive,
if not curative remedy against tuberculous acidity. According
to ANCELL crude tubercle contains but a very small proportion
of Phosphate and Carbonate of Lime-say one per cent.



TUBERCLES OF THE BRAIN.                 75
whereas, chalky tubercles frequently weigh 10, 20 or 30 grains.
Hence in order to form chalky concretions, the deposition and
resorption of animal matter, such as Albumen and Caseine must
have taken place to a very great extent, or for a considerable
period.  It appears to ANCELL that where the tendency to
cretaceous aggregation has existed in the highest degree, the
blood must have wholly or partially lost its tuberculous quality;
and that after having secreted intractable tubercle, owing to
this favorable change it pours out a blastema, which depositing
its earthy salts, is in the main susceptible of resorption, and is
actually absorbed, the earthy particles gradually accumulating
in the tuberculous cavity. That some such process as this occurs, he thinks, follows from a consideration of the whole series
of chemical facts.  Supplying an excess of Phosphate of Lime
to the system may perhaps favor and hasten these beneficial
changes.
The acids in the normal gastric juice are: the Muriatic, Lactic and Acetic; the Muriatic generally predominates, although
either may be in excess and require peculiar treatment. The
chyme which is made from the fibrine of meat and coagulated
albumen, contains much NIluriatic acid; that which is made
from quite fresh meat and milk contains an excess of Lactic
acid; while that which is made from amylaceous and farinaceous substances and vegetables contains much Acetic acid. In
some states of the system  quite new and unusual acids are
found, or get into the stomach, such as: Phosphoric, Uric,
Oleic or Butyric, and even Fluoric acid. It is not yet known
positively which one of these acids predominates in the tuberculous dyscrasia, but they all require their peculiar and specific
antidotes. The best antidotes of Muriatic acid are: Zincum,
Ferrum, Argentum and Ammonia; Soda, Plumbum and Baryta
are the best antidotes for Phosphoric acid; the tendency to the
formation of Uric acid in the stomach is best antidoted by Cuprum and Colchicum; while an excess of Lactic acid is best
met with Zincum. —(See Treatise on Diseases of Married Females, p. 52.)
Hepar-sulphur. may correct acidity of the stomach, and neutralize the predominance of albumen in the blood, besides having
a symptomatic relation to tubercular disease.




76              TUBERCLES OF THE BRAIN.
When deposits of tubercle have actually taken place, they
cannot be removed by any known solvent. Still trials may be
made with at least a shadow of a hope of success. Thus. if we
admit with IHECHT and SCHARLAU that tubercle contains 30
per cent. of Fibrine, the solvents of Fibrine may be used. According to DENIS if moist Fibrine be digested in a solution of
Nitrate of Potash containing a little Soda, it gradually becomes
converted into a substance in almost every respect identical
with Albumen; being soluble in water, and coagulable by heat.
Again, the alkalies and their carbonates and acetates entirely
prevent the coagulation of Fibrine; and tolerably strong solutions of Nitrate of Potash, Nitrate of Lime, and Muriate of
Ammonia, retard it for a long time; the Muriate of Ammonia,
indeed, gradually dissolves Fibrine, after it has been allowed to
coagulate.
If we assume that tubercle consists in an excessive formation
and deposition of Albumen, the solvents of Albumen may be
tried. Hepar-sulphur. has already been alluded to. Coagulated Albumen is also readily soluble in Potash and other alkaline solutions; the Phosphoric, Acetic and Tartaric acids, also
appear to exercise a decided solvent action upon it, and when
present even prevent its coagulating on the application of heat.
On the other hand, the Nitric and Muriatic acids, the Bichloride
of Mercury, and Ferrocyanide of Potassium coagulate and precipitate Albumen and hence may be more homceopathic to Albuminous tubercles.
Finally, if we assume that tubercle consists merely of Caseine,
we may be obliged to resort to Acetic, or some other acid, for
although Caseine coagulates and is precipitated by Acetic
acid, it redissolves if the acid be added in decided excess. In
fact, although Caseine is precipitated and coagulated by Acetic
and nearly all the acids, it redissolves in a considerable excess
of most of them.
The experienced physician can easily decide when to give the
preference to one or the other of these remedies; or to use two
or several of them in alternation or combination; also when it
will be advisable to use the inhalation of the vapors of these
medicines in combination with their internal use; and finally
when to rely upon infinitessimal quantities in order to overcome




CANCER OF THE BRAIN.                   77
a qualitative or dynamic predisposition or tendency to tubercular disease, and when to give more massive quantities in order
to remove absolutely material and quantitative deposits.
CANCER OF THE BRAIN.
THi: symptoms of cancer of the brain and its membranes are
similar if not identical with those of tubercles or other tumors
of these parts. An accurate diagnosis is seldom more than conjectured, except when the cerebral symptoms happen to coincide
with the phenomena observed in other parts of the body, which
may serve as a clue to the disease going on in the brain. Thus,
tubercles in the brain are more common in children and young
adults; hard cancer, is more common in persons over 40, while
medullary cancer may occur in young subjects. In tubercular
disease the skin is apt to present a pasty or doughy appearance;
in cancer it often presents a peculiar straw-yellow color. As
WATSON truly observes various local diseases and tumors of the
brain, do not disclose their precise nature by any peculiar
symptoms or succession of symptoms; but if we detect signs of
tuberculous or cancerous disease in other parts of the body, we
may safely infer that the symptoms which denote disease of the
brain are caused by tuberculous or cancerous disease there
situated; but from the symptoms alone, we can only learn that
there is some morbid condition of the brain. If there be signs
of disease of the lungs, bronchial glands, peritoneum or bowels,
the probability is that the disease is tuberculous. If there be
disease of the breasts. axillary glands, womb, &c., &c., the
probability is that the disease is cancerous.
Hence the treatment, although it may be honmeopathic, must
not be merely symptomatic; it must be directed against the
nature of the disease, and not merely against its symptoms or
manifestations.
However similar the symptoms of tubercular and cancerous
disease of the brain may be, viz.: headache, blindness, paralysis,
convulsions, &c., &c. yet there is a decided antagonism not
only in the nature of the two diseases, but also in the localities which they prefer: thus, cancer of the breast, stomach,




78                CANCER OF THE BRAIN.
liver, large bowels and womb, is very common; tubercular disease of these organs is very rare; tubercular disease of the
lungs, spleen, small bowels, bronchial glands, peritonumm;, &c.,
is sufficiently common, while cancerous affections of these organs
is decidedly rare. Hence the remedies for cancerous disease
may or must be injurious in tubercular disease, and vice versa.
In tuberculosis, the cellular, vascular, albuminous and glandular tissues are most apt to be affected; in cancerous disease,
the gelatiniform, fibrous, albuminous or medullary and glandular
parts.  Caseine and Albumen are the predominant elements in
the tuberculous dyscrasia; Gelatine, Fibrine, Phosphorised fat,
Cholesterine, and perhaps Albumen are the most abundant constituents in cancer. Caseine is never found in cancer.
In scirrhus we may find from 0.2144 to 0.2778 of Gelatine;
0.1428 of Fibrine; 0.1388 of Phosphorized fat; and 0.0278 of
Albumen; the rest water and salts.
Treatment. —The best remedies against the cancerous dyscrasia, are: Arsenicum, Alumina, Carbo-animalis, Soot, Calendula, Muriates of Gold and Soda, Donovan's Solution, &co




ON THE
HOMT(EOPATHIIC TREATMENT
OF
INFLAMMATION AND DROPSY OF TIlE BRAIN,
&c., &c.
THE following remedies have been used most frequently,
viz.: Aconite, Arnica, Belladonna, Bryonia, Chamomilla, Cuprum, Digitalis, Hellebore, Hyosciamus, Iodine, Opium, Rhus,
Spts.-Nit.-dulc., Stramonium, Sulphur, Veratrum and Zinc.
AcONITE.
GENERAL REM ARKS.-According to WARING the comparative activity of the different parts of the plant has been closely
examined by Drs. FLEMING and TURNBULL. They agree that
the root is the part which is most energetic, certain and eligible for medicinal use; the seeds rank second; the leaves third;
theflowers fourth, and thefruit and stem last. The homceopathic tincture which is made from the whole plant is much weaker
and more inefficient than the tincture of the root, because the
root contains a much larger proportion of the active principle
of the plant, (Aconitine,) than any other part, or all other parts
combined. When the homoeopathic tincture is diluted one-half,
or even twenty times as it frequently is, it becomes a very uncertain and weak preparation to combat acute congestive or inflammatory affections, because Aconite is antipathic rather than
homoeopathic to these affections, and hence tangible or even massive doses are required. Although Aconite resembles Digitalis
and Tobacco in its action upon the heart and arteries and is not




80                        ACONITE.
strictly homcopathic to inflammatory or actively congestive diseases, still it is used as a matter of course, or of routine, by the
majority of homeeopathists against the majority of these affections; consequently it frequently fails to produce any good effect,
especially when the dilutions, either high or low are used. Lately, iDr. HIENRY, homoeopathic physician in Montgomery, Alabama, has found out that the Veratrum-viride, exerts a still
mnore powerful action upon the heart and arteries; predicts
that it will soon stand as a great rival to the long tried Aconite;
and asserts that he prefers it to Aconite, and has never failed
in reducing the action of the heart with it.  Singularly enough,
Veratrum-viride is quite as antipathic to fever and inflammation
as Aconite.
According to FLEMING and WARING, when a small piece
of the root of Aconite is chewed, it causes an increased flow of
saliva, a peculiar numbness of the lips and tongue, with a tingling sensation, and partial loss of use of the lips. Its topical
application is unaccompanied by either pain, redness or swelling,
even when its pathogenetic effects are developed to the fullest
extent; proving that it is not homceopathic to inflammation, but
that it exerts a depressing and benumbing, or paralyzing effect
upon the vascular system and nerves of sensation.
Given internally, Dr. FLEMING, divides its operation into
four degrees:
First Degree. —Half an hour after a dose of 5 drops of the
Tincture of the Root, warmth is felt in the stomach, with slight
nausea, oppression of breathing, general warmth of the body,
numbness, tingling and a sense of distension of the throat, lips
and tongue. There is also a tingling at the tips of the fingers,
with a peculiar sensation at the roots of the teeth; slight muscular weakness is generally experienced, with indisposition for
exertion, either mental or bodily. In about half an hour more,
the pulse will be found diminished in strength, and in'another
hour both the pulse and breathing will have become less frequent, viz.: the pulse will have fallen from 72 to 64, and the
breathing from 18 to 15 or 16.
ASecond Degree.-If 10 drops be taken at first, or the original dose of 5 drops, be followed in two hours by another of
equal amount, the above symptoms will supervene more rapidly




ACONITE.                        81
and with greater severity. The tingling will extend up along
the arms, and the sensitiveness of the skin is more or less impaired. In one and a half hours, the pulse will probably have
fallen to about 56 beats per minute and become smaller and
weaker, still maintaining, however, perfect regularity.  The
respirations will be about 13 per minute and laboring, attended
with great muscular debility, giddiness and confusion of sight,
with lethargy, coldness of the skin and extremities.
Larger doses will be followed by the same symptoms to a
more severe extent. The pulse occasionally falls to 40, or even
36, but more generally rises to 70 or 80, becoming small, weak
and irregular; respiration is oppressed, and the skin becomes
moist and cold. FLEMING.
Of the allied remedies of Aconite, Tobacco acts specifically
upon the stomach, solar plexus of nerves, heart, arteries and
nerves of motion and muscular system.  Digitalis acts principally upon the heart, arteries, kidneys, and serous membranes.   Veratrum-viride upon the stomach, liver, bowels,
heart and arteries.  Colchicum upon the liver, kidneys, heart,
arteries and fibrous tissues.  Tartar-emetic and Ipecac. upon
the stomach, solar plexus, skin and muscular system. Aconite
upon the skin, sero-fibrous tissues, heart and arteries.  All
these remedies depress the action of the heart and arteries in a
similar and specific manner.
Although I believe that the majority of TESTE's remarks on
the Materia Medica are flippant and insincere, still I agree
with him when he says, that of all the medicines used by homoeopathic physicians, Aconite is the one which they use erroneously most frequently.  As it only possesses the power of
perturbating or depressing the action of the heart and arteries,
and is not homceopathic to inflammatory local lesions, whenever
inflammatory fever and local inflammation have already acquired
a certain degree of intensity, infinitessimal doses cannot be
administered without involving a loss of very precious time.
Either, some decidedly homoeopathic remedy must be used in
small quantities; or more massive doses of Aconite must be
given.  TESSIER found that when inflammation of the lungs
was at its height, the high dilutions only produced some
slight effect upon the pulse, none upon the disease. —PETERS.
F




82                      ACONITE.
za. In opposition to the above, KIREUSSLER SayS: whenever
traces merely of inflammation of the brain present themselves,
or whenever this disease seems fully developed, Aconite is the
first remedy which oight to be given. It is not the question
whether inflammatory fever is present or not, for pure inflammation of the brain or its membranes requires the use of this
remedy from the very commencement of the disease, until effusions and exudations have taken place. Two or three doses of
the 6th or 12th dilution may be given, ana Jts action awaited
for twelve or twenty-four hours. If not the least;improvement
occurs during this time, viz.: neither perspiration, setiment in
the urine, nor bleeding of the nose, and the restlessness continues, followed by stupor and delirium, then another remedy
must be used. —KREUSSLER. I venture to assert that either
other remedies, or larger doses will be required in the majority
of cases.-PETERS.
b. HEICHELHEIM Says he has treated eight children in the
first stage of dropsy of the brain and relieved them all with
Aconite followed by Bellad.
c. SCHROEN asserts that when congestion of the brain with
impending inflammation sets in during dentition of young children, he has always found Aconite useful; but large and rex
peated doses had to be given. KREUSSLER, with characteristic
flippancy and dogmatism assumes that Aconite will not remove
simple congestion, but only that stasis and congestion which is
the first stage of acute inflammation.
CASE 1.-A  girl, aged 10, had heat and redness of the
whole body, especially of the head and eyes, contracted pupils,
entire unconsciousness, delirium, dryness of the tongue, vomiting of greenish substances, subsultus, quickened respiration,
pulse 120 to 130, with grasping at the head.
Treatment and Result. —Aon. 18, one drop in 6 spoonsful
of water, 1 spoonful every half-hour; in six hours consciousness
was restored, the fever and vomiting had ceased; Bryonia was
given on the next day, and she was quite well in two days more.
-GASTFREUND.
CASE 2.-A  lady, aged 32, who had often suffered with
zevere headache, was suddenly attacked with symptoms which




ACONITE.                      83
denoted approaching inflammation of the brain. She ran in
perfect despair about the room, complained of pain in the forehead, as if everything would be forced out of it; her head was
glowing hot; she had nausea, white coated tongue, pain in the
back, constipation for two days; pulse tranquil, and skin natural.-[I have frequently seen similar attacks in nervous and
hysterical females, but never supposed that I had either threatened or actual inflammation to deal with.]-PETERS.
Treatment. —Aconite 6, 1 drop; in fivp minutes the pain
abated; the patient soon became composed and slept till morning, when she was quite restored.-KREUSSLER.
CASE  3.-A boy, aged 5 years, sickened with the usual
signs of inflammation of the brain, of which the following were
the most prominent:
Symmptoms.-Spasms of the limbs, alternating with trembling
motion of them; vomiting of food or mucus as soon as he raised
his head; starting up from sleep with delirium, or pain in both
sides of the head; dryness and heat of skin; much thirst; full,
hard and quick pulse.
Treatment.-Aconite 30, in 2 ounces of water, 1 teaspoonful
every hour at first, then every two hours, with perfect recovery
in three days.-WEBER.
CASE 4.-A maiden, aged 14, had suffered for twentyfour hours with the following symptoms of brain-affection:
vertigo and vomiting whenever she rose up; constant pain in
the forehead; delirium, sopor, screaming and starting up from
sleep, with fixedness of look; her face was pale at times, at
others red; skin hot and dry; thirst, and constipation.
Treatment. -14 doses of Aconite 30, removed the whole
disorder in three days. The constipation was removed by Nux.
30.-WEBER.
CASE 5.-A girl, aged nine years, was attacked with inflammation of the brain, for which she received Bell. 4, 1 drop
every three hours, for thirty-one hours without benefit.
Symptoms.-Wandering of the mind; constant chewing motion of the lower jaw; incoherent muttering; the pupils were
contracted; expression of the eyes unsteady and indifferent;




84                      ACONITE.
face moderately flushed; skin moist; pulse full, hard, quick
and frequent.
Treatment.-Aconite 3, 1 drop every hour; in five hours
she fell asleep and slept for four hours; she awoke conscious,
and was gradually rest6red on the third day. — NOACK.
CASE 6. —HAUBOLD cured a case of acute hydrocephalus,
attended with vomiting; boring of the very large head into the
pillow; by means of three doses of Aconite in thirty-six hours,
followed by 1 dose of Bellad.
CASE 7. —After a somewhat hard fall upon the head, a boy,
aged 2 years, was attacked suddenly with the following:
Symptoms. —He dozed a great deal, but often awoke suddenly, raised himself up and vomited up a clear, watery fluid;
his tongue was clean and he drank again immediately afterwardsj then fell asleep and awoke vomiting at least three times
in every hour. He frequently started in his sleep; had rolling
of his half-opened eyes; bored the back of his head into the
pillow; grasped at his head automatically; frequent alternations of the color of his face from pale to red; picking of his
nose; and gritting of the teeth.
Treatment.-Two doses of Aconite 3, 1 drop per dose, every
hour; followed by Bellad. 3, 1 drop every two hours. On the
following day he was quite well. —FRANK.
CASE 8.-A child, aged 3 years, was attacked with inflammation of the membranes of the brain, which terminated in
effusion into the ventricles. It was given up as hopeless by
two physicians.
Treatment. —Aconite was then given every half-hour, until
the quickness of the pulse was lessened; then Bellad. was
given in the same way. The child improved in some days,
and had completely recovered at the end of a fortnight. —DUNsFORD.
CASE 9. —YELDHAM  thinks that many of the slighter affections of the brain, giving rise to headache, and other symptoms clearly referable to disorder of that organ, are doubtless
of an inflammatory character. Hence he would doubtless meet
with, and cure more cases of inflammation of the brain than
most other physicians.-PETERS.




ACONITE.                       85
A hearty young man, aged 20, caught cold on his journey
home, about a week ago; yesterday was seized with shivering
and violent pain in the head; took pills which acted freely, but
without relief; he lies with his neck stretched out and head
thrown back on the pillow, from which position he cannot bear
to move; complains of intense pain in the forehead over the
eyes; cannot tolerate the least light or noise; his brow is knit;
eyes red and angry; his skin, especially that of the forehead is
hot and dry; pulse 95, full and hard; mouth and tongue dry,
with incessant thirst; no other pain, but is liable to rush of
blood to the head.
Treatment.-Aconite 3, directly followed by Bellad. 3, every
two hours; was rather better the next day; head not so hot
and painful; thirst not so urgent; pulse as frequent, but not
so hard and throbbing; skin cooler.-Aconite 3, and Bellad. 3,
in alternation every three hours; recovered entirely in two days
more.
REVIEW. —Of nine cases, 7 were in children, and two in
adults.
In case 7, a fall upon the head was the exciting cause.
Vomiting was present in 4 cases.
In most of the cases there was a state of excitement, with
delirium, spasms, subsultus, &c., &c.; the pulse varied from
72 to 95, or even 120 or 130, and was full, hard, quick or suppressed.  Yet in cases of poisoning with Aconite, the brain
is remarkably undisturbed and clear, and the pulse is apt to be
weak, small and slow.-PETERS.
The stage in which it proved most useful was that of irritation, only occasionally approaching that of exudation.
DosEs:-Aconite 3, was given twice, in repeated doses;
Aconite 6, once; Aconite 18, once in solution, and repeated
every half-hour; Aconite 30, twice in solution.
In 3 cases Aconite effected a cure alone.'" 5  c"    " - was followed by Bellad.
"C 1  c     "     " a    c       Bryon.
The duration of the attacks was twenty-four hours in 1 case;
thirty-six hours in 1 case; three days in 5 cases; and fourteen days in 1 case.




86                        ARNICA.
Aconite probably acts as a powerful antiphlogistic sudorific,
as it induces perspiration in the majority of acute cases in
which it proves beneficial.
ARNI CA.
According to SOBERNHE1M it facilitates the circulation of the
lymph, and increases the absorbent powers of the collective
lymphatic and venous systems.  It was used and highly recommended in arachnitis with effusion by the celebrated G6LIs   of
Vienna; he had the head of the patient freely and frequently
bathed with an infusion of Arnica, when signs of effusion or
exudation, or of a sub-paralytic state of the brain came on; —he
also regarded it as the principal remedy against concussions of
the brain, or spinal marrow; in sanguineous, or sero-lymphatic
exudations from falls, blows, contusions, concussions, &c. It is
very useful in low states of the system when there is dulness
of the senses, dejection of spirits, drowsiness, sopor, or even stupor, or muttering delirium with dryness and blackness of the
tongue, &c., &c.  If it fails, Hydriodate of Potash may be
used internally and externally, aided or not by a few doses of
Iodide of Mercury, or of Apocynum-cannabinum.-PETERS.
CASE 10.-A delicate boy, aged 21 years, was attacked
with the following symptoms about five weeks after he had had
an attack of measles.
He complained of pain in his head; squinted; was afraid of
falling, and at times even fell backwards; he had attacks of
vomiting, cramps of the hands, and fits of screaming; was only
comfortable while lying upon his back; had attacks of unconsciousness, from which he could only be aroused by loud
talking; his head was hot; pupils dilated; breathing anxious;
urine scanty and red; pulse quick and small.
Treatment and Result.-Aconite 9, followed in three hours
by Bellad. 12; but the disease increased steadily for nine
hours, when he became exceedingly restless, with severe convulsions of the limbs, violent fits of screaming; hle was only
easy when lying on his right side, with his head bent far back;
the pupils were very much dilated; eyes entirely insensible to
light; he was perfectly unconscious, and grasped at his head.




ARSENICUM.                      87
Arnica 3, in 1 drop doses; by the next night he could open his
eyes; his consciousness returned the next morning; he wished
for food, and to be carried about, but was unable to hold his
head up; the pupils were somewhat contracted; his urine turbid, with a yellow sediment; and he was very irritable. On
the second day he attempted to stand, but fell over; Arnica 6
was given. On the third day, a return of fever was removed
by Aconite.  On the fifth day he seemed restored and had
some appetite. Merc. 2 finally restored him perfectly in fourteen days. —MALY.
CASE  11. —In a case of acute hydrocephalus, in which
Aecon. and Bell. afforded no relief, Arnica 6, repeated every
four hours, effected a rapid improvement. -IAUBOLD.
CASE 12. —Inflammation of the brain with violent symptoms in a maiden, aged 21, arising from a fall upon the head,
was soon removed by several doses of Arnica 4; remaining
blindness was cured by Bellad. and Opium. —THORER.
REVIEW.-It has been decidedly useful in the second stage
of hydrocephalus, especially when induced by falls or blows
upon the head.
ARSENICUM.
This remedy ought to prove one of the most efficient homceopathic remedies against serous inflammations in general and
inflammatory dropsies.  One of its most marked and frequent
effects is to produce dropsical effusions about the head and face,
attended with fever and great scantiness of the urine. It is
most homoeopathic to the acute variety of hydrocephalus, yet
WAHLE only recommends it in the chronic form, after the previous use of Hellebore and Sulphur, and when the patient is
peculiarly irritable and passionate.
CASE 13.-A boy, aged 6 years, had been drooping for
some time, finally he had all the symptoms of brain-disease, accompanied by gastric derangement; he lay doubled up in bed,
with his knees drawn up to his stomach; bowels very sensitive
to touch; was drowsy and heavy, and lay in a stupor with halfclosed eyes and open mouth, whenever he was not disturbed;




88                    BELLADONNA.
when aroused, and also at other times he often started and
screamed out with a loud and piercing cry; his features were
sunken; mouth and nostrils sore, dry and black; his tongue
dry and parched, with a thick, brownish-yellow coating; red
edges and papillae. The skin of his whole body, but more particularly of the head and bowels was hot and dry; he was
thirsty and had no appetite; his bowels loose and evacuations
unhealthy; pulse 125, hard and incompressible; he was annoyed by a short hacking cough.
Treatment.-Arsenicum 6, every four hours; at the end of
two days he seemed much the same, only his tongue appeared
to be cleaning at the edges, and his thirst was not so great.
The Arsenicurn was continued for three days more, with only
slight shades of amendment; he was then ordered Hellebore 6,
every four hours, with decided improvement at the end of the
second day; his tongue became moist and cleaned off rapidly;
skin cool, thirst moderate, pulse less frequent and more soft,
eyes clear, bright and intelligent, little or no screaming or
drowsiness.  He was perfectly restored in a few days more,
under the continued use of Hlellebore.-YELDI~IAM.
BELLADONNA.
GENERAL REMARKS.-a. This remedy acts specifically upon
the blood, brain, nervous, muscular and lymphatic systems, also
upon the throat, skin and kidneys.
Its action upon the blood is similar to that produced by Alcohol, or extreme heat of the sun; there is a commotion and
actual expansion of the blood, as is shown by the quickness and
fulness of the blood-vessels. heat and redness of the face and skin.
It would seem to cause an intense arterial and inflammatory
condition, but in fact it causes a tumultuous conversion of the
arterial blood into venous, for after a while the apparent increased arterial action ceases, and excessive and predominant
venosity supplies its place. The apparent arterial storm lasts
for about twelve hours, when great venosity becomes apparent;
the redness of the face gives place to lividity; the veins everywhere seem to be crowded and overfilled; the muscles become
relaxed; confusion and stupefaction of the brain ensue; but




BELLADONINA.                       89
finally profuse sweats and urination restore the balance of the
system.
It may be that this powerful commotion and intoxication of
the arterial system is removed by the exertions or natural
functions of the venous and lymphatic systems. which absorb or
remove the noxious element from the arterial system, and thus
become contaminated themselves.
Its action upon the brain is that of a powerful irritant or
stimulant, unless the dose be in great excess, when the powers
of the brain are completely overcome or stupefied; Belladonna
stupefaction may also arise from exhaustion from previous overexcitement.-(See Treatise on Mental Derangement.)
Its action upon the muscular system  is rather depressing
than exciting; Belladonna convulsions are rare, and when present slight; while paralysis of the sphincters, such as dilatation
of the pupils, of the neck of the bladder, womb, and the rectum
are common; besides it is one of the best palliatives against
those wandering pains in rheumatism, which arise from spasmodic contraction of the muscles, caused by the fleeting irritation of the poison of rheumatism; also against rheumatic colicky
pains from  spasmodic contraction of the muscular coat of the
stomach and bowels.
Its action upon the throat and skin is similar to that produced by the poison of scarlet fever.
Its action upon the kidneys is very decided; the secretion of
urine is increased excessively.-PETERS.
b. LOBETHAL says he gives 2 or 3 drops of the tincture of
Bellad. in several spoonsful of water, against violent congestion
towards the head in young children, with threatening of inflammation or dropsy of the brain, with far more confidence
than he does the 24th or 30th dilution. In slighter and more
chronic cases, in some of the latter of which he has several
times succeeded in effecting cures even when. there was entire
dulness of the senses, he prefers the 24th or 30th dilutions to
the lower potencies.
c. KREUssLER advises the 18th or 24th dilution, repeated
twice a day, when there are aching and outward pressing pains
with dull stitches in the head, preceded by dizziness and feeling




90                     BELLADONNA.
of intoxication; when the patients stare fixedly before them,
and their faces and eyes are much flushed; when infants bore
with their heads into the pillow; also when there is retention
of f~eces and urine, which afterwards pass off involuntarily; the
thirst being excessive, the pulse frequent and quick. When
improvement sets in the doses are to be repeated less frequently
than twice a day.
d. KNORRE thinks that Bellad. is most indicated in thefirst,
or inflammatory stage of hydrocephalus, when this is strongly
marked and bears an arterial, or venous-inflammatory character rather than a torpid or, sub-inflammatory.  In the second, or
incurable stage it is of no further avail, except that it sometimes
relieves the vomiting, and that perhaps only imperfectly.
IN CHILDREN.
CASE 14.-A girl, aged 6 years, after several days' sickness,
had the following:
S~ynmptorns.-Acute fever, general heat of body, redness of
the face, quick, hard pulse, quick breathing, sleepy-drowsiness,
frequent vomiting, gritting of the teeth, and great anxiety and
restlessness while awake.
Treatmenzt. —Bellad. 3, 15 drops in 3 ounces of water, 1 teaspoonful every hour; with relief in twenty-four hours and
speedy recovery.-ELwERT.
CASE 15.-A  boy, aged 6, had been sick for six or eight
hours, with violent fever, quick pulse, hurried breathing, trembling, great redness of face, general dry heat of skin, drowsiness, frequent starting, fixed and glassy look, cramp of the
jaws.
Treatmnent.-Bellad. 3 relieved him in twenty-four hours.ELWERT.
CASE 16.-A boy, aged 5, had suffered for several hours
with active fever and nervous excitement.  he received Aconite
3, followed by general perspiration and by increase of the disease; he was aroused with difficulty, stared fixedly, and did not
understand when spoken to, had startings and tremblings of




BELLADONNA.                       91
the limbs, jerks, twitchings of the muscles of the face; pulse
not to be counted and respiration hurried.
Treatmlent.- Bellad. 3, 10 drops in 3 ounces of water, 1 teaspoonful every half-hour, with evident improvement in twentyfour hours. —ELWERT.
CASES 17 and 18.-Two similar cases were treated with
Bellad., one with 15 drops of the tincture in two ounces of
water, the other with the second dilution; the doses were repeated every quarter or half-hour. —ELWE.RT.
CASE 19.-A girl, aged 5 years, had been sick for twentyfour hours; she had passed a sleepless night, screamed, raged,
spoke in a confused manner, her face was bright red, forehead
hot, eyes glassy, protruding and injected, the carotids beat
violently, pulse could not be felt on account of her restlessness;
urination involuntary.
Treatment. —3 doses of Bellad. 30, cured her so quickly that
she could leave her bed on the fifth day.-SCHWARZE.
CASE 20.-A male infant, aged 13 weeks, had three attacks
at short intervals of time, as follows:
SyTmptoms.-IRed, scarlet-colored spots appeared upon the
abdomen, and after they disappeared he had constant drowsiness, squinting and rolling of the eyes, frothy mucus before the
mouth, green stools and whitish urine; he was only aroused
from his stupor by attacks of suffocative cough.
Treatmtent. —6 doses of Bellad. 30, 1 dose every twenty-four,
thirty-six or forty-eight hours removed the brain-affection in six
days; the suffocative cough, with vomiting, greenish and fluid
stools were removed by Ipecac. 30, followed in twenty-four
hours by Veratrum, in the course of five days more.-Dr. B.
in D
CASE 21. —A delicate boy, aged 8, played for a long time
in the sun on a hot July day; soon after he was attacked with
violent headache, fever, drowsiness and stupor; every quarter
or half-hour he Would start up suddenly, with shrill screams,
then mutter several words, and grasp at his head; his pupils
were unequally dilated, especially the right; his face much
reddened; skin burning hot; and fever ran very high.




92                     BELLADONNA.
Treatment.-Bellad. and Acon. 6, in solution, every two
hours; after a few doses, profuse perspiration set in and lasted
all night; he awoke in the morning as after a long sleep, and
was quite restored in the course of the day.-IRAMPAL.
CASE 22.-A  4 year old, spongy and ricketty child, was
attacked with fever attended with evening and night-aggravations, violent headache, and inability to sit up.
Treatment. —1l dose of Bellad. 24, benefitted him so much in
twenty-four hours that all danger seemed over.  A  similar
attack in a healthy 3 year old child, was cured by the same
treatment.- MORITZ MfiLLER.
CASE 23.-A healthy girl, aged 8, was exposed to the hot
sun in July, and became sick on the following night; she was
treated allopathically for several days, and was left with the
following:
&snymptovns. —~iolent headache, face pale and suffering, unconsciousness, with delirium  about food; she was constantly
boring her fingers in her nose, had great heat of the body with
thirst, and some perspiration upon the head.
Treatmnent.-Bell. 30, followed by sound sleep for several
hours, from which she awoke better, but with a violent cough,
which caused severe pains in the head. Bryon. 12, 2 doses in
twenty-four hours completed the cure. —SEGIN.
CASE 24.-A delicate child, aged 3 years, who had had two
attacks of inflammatory brain-affection, and recovered under
allopathic treatment, was taken with a third and very violent
paroxysm. Bellad. 3, 1 drop in divided doses soon-relieved her.
-SEGIN.
It is doubtful whether any child would survive three attacks
of inflammation of the brain under any mode of treatment.PETERS.
CASE 25.-A  strong and well-nourished child, aged nine
months, became restless, coughed much, started in its sleep,
and was attacked with repeated convulsive movements of the
face and limbs.
Treatment.-Bellad. 30, produced rapid relief; a similar
attack, eight days after, was relieved in the same way; but in




BELLADONNA.                       93
two days more there was a second relapse, attended with a red,
psydracious eruption. Bellad. 30, followed by Sulph. 80, effected a radical cure.-SEGIN.
CASE 26.-A male child, aged 3 years, whose brother had
died a year before of inflammation of the brain, was attacked
with similar signs of commencing disease.
Treatlzent.- Bellad. 30, only relieved the vomniting; but
after 4 doses of Aconite 24, followed on the next day by Bellad.
30, a rapid improvement ensued, and perfect recovery on the
fourth day.-SEGIN.
CASE 27.-A  robust boy, aged 10 months, had been sick
for two days.
Syrnptonis.-Lachrymose, irritable and restless' at night;
sleeplessness, or half-slumber with frequent startings; pungent, dry heat; hanging backwards of the head; jaws dropped;
and seemed to have thirst, but rejected the proffered drink;
loose stools, with some straining.
Treatnzent.-Bellad. 30, at night; his sleep was more quiet,
was more lively in the morning, but still irritable and inclined
to cry. A violent increase of fever was relieved by 2 doses of
Aconite 24, and on the fifth day of the disease the fever n as
very slight, but the irritability and depression were great.
Bellad. 30: was followed by quiet sleep, pleasant awaking,
moderate heat, profuse sweat and urination during the day, and
greater clearness of mind.  Recovery on the fourth day of
treatment, and sixth day of the disease.-SEGIN.
CASE 28.-A child, aged 2~ years, whose sister had died
one year before of inflammation of the brain under allopathic
treatment, was treated allopathically for several days, constantly growing worse.
Sytnptoms.-Sensitive, irritable, lachrymose, half-slumber
fronm which it often started up in a fright; frequent flushes of
fever; a red, moist eruption behind the ears.
Treatnzent.-Bellad. 12, repeated in three hours; in five
hours after the second dose, she was more quiet; 3 more doses
of Bellad. were followed by quiet night sleep, and earache in the
morning. Sulph. 12, was followed by boring with the fingers
in the mouth, nose and ears, and profuse urination.  Bellad.




94                    BFELLADONNA.
12, followed in twenty-four hours by Mere. 1 and Sulphur,
effected a recovery on the fifteenth day of treatment.-SEGIN.
CASE 29.-A boy, aged 7 months, was suddenly attacked
with frequently repeated vomitings, high fever and involuntary
movenments of the facial muscles and arms; also with great
restlessness, constant boring of the head in the pillow, and remarkably dilated pupils.
Treatment.-Bellad. 5, four doses, one every two hours, from
evening until midnight; after two o'clock at night, all these
threatening symptoms subsided, and he was quite well on the
next day. —SEGIN.
CASE  0. —A boy, aged 7 years, very sensitive and delicate,
with tendency to scrofula, was attacked suddenly, five weeks
after having the measles, with violent fever, pulse full and 100,
skin dry and hot, especially on the head and stomach, eyes
brilliant and injected, also sensitive to light, pupils contracted,
thirst and constipation.
Treatment.-Aconite 1st dilution, 6 drops in solution, 1 teaspoonful every half-hour; at the end of four hours the symptoms had much increased, pulse was very hard, full and 150,
with violent throbbing of the carotid and temporal arteries; the
skin of the whole body was glowing hot and dry; face red and
bloated; eyes still more reddened, and sensitive to light, and
only one-half closed during sleep; there was deliriun, with
grasping of the hands at the bed clothes; and great dryness of
the tongue.
Treatmnent.-Bellad., 1st dilution, 10 drops in water, 1 teaspoonful every half-hour in alternation with Aconite, also cold
applications to the head; perspiration sat in some time after
midnight, followed by greater quiet, and return of consciousness
in the morning; the pulse was soft and had fallen to 120; after
a restless night he had a movement of the bowels on the third
morning and pulse fell to 100. Bellad. 3, three drops in solution,
one teaspoonful every hour, was followed by recovery on the
fourth day.-SCHIWEICKERT.
CASE 31.-A girl aged 5, had been sick for three days.
symptoms.-Face hot, red and bloated; boring with the
head into the pillow; eyes half open during sleep, or else much




BELLADONNA,                      95
distorted; much thirst, no appetite, stools seldom and in small
hard lumps; jaw dropped; nose quite dry; grasping at the
head, during the heavy sleep; sudden starting up in a fright,
with anxious staring about, and quick relapse into stupor.
Treatmnent.-Bellad. 30, followed by sound sleep for two
hours, and speedy recovery.-BETHMANN.
CASE 32.-A little girl, aged 2A- years, had been failing in
health for some time; three nights ago became hot and feverish,
and soon became very ill indeed; lying about the room, complaining of headache, and referring all her suffering to her head,
she was drowsy and heavy; eyelids drooping; eyes sunk deep
in their sockets; mouth parched; cheeks flushed; head and
body dry and hot; pulse quick and throbbing; tongue white,
with red points upon it; great thirst; quick breathing, some
cough; bowels quite regular; she avoided light and was distressed at the least noise; starts suddenly from her sleep, and
screams as if frightened.
Treatment.-Aconite 12, every four hours, without benefit,
as she still remained drowsy, with constant starting and screaming, heat and thirst.  Belladonna 6, every two hours, followed
by great relief, fever and thirst diminished, slept well, did not
scream or start, tongue cleaning, her look was placid and intelligent, and she was able to sit up a little. Continued ]Bellad. 6,
three times a day, and was quite restored on the sixth day.YELDHIAIM.
CASE  33.-Threatefied hydrocephalus.  A  delicate boy,
aged 5, has been complaining for some time of headachle, loss
of appetite and listlessness; is now quite chilly, creeping into
the fire, although a very warm day; has a staring, unmeaning
look; does not answer when spoken to; pupils sluggish; pulse
slow and feeble.  The parents state that they have already
lost two children with dropsy of the brain, and fear that this
little boy is going off in the same manner.
Treatzment.-3Bellad. 3, and Ipecac. 3, in alternation; on the
next day there was some improvement.  Bellad. 3, and Tinct.sulph. in alternation; in five days more he was almost well, and
the cure was completed by Pulsatilla 3.




96                     BELLADONNA.
Subsequently his little sister was affected in much the same
way, and was restored by similar treatment.-Brit. Jour. Hom.
Vol. 9, p. 585. —Dr. SHARP.
6Cates which cppr1oach the second stage of Acute
Hydlocephawstc.
CASE 34.-A boy, aged 31 years, after headache for several
days, was attacked with violent vomiting, heavy stupor with
snoring, from  which he could hardly be roused; convulsive
starts shook his whole body occasionally; his head was glowing
hot, and thrown backwards; his cheeks alternated from glowing
red, to pale; eyes rigid, insensible, glassy, somewhat reddened,
half-open, and turned. upwards; pupils dilated, at times insensible to light; breathing quick, deep, heavy and hot; pulse full
and hard at times, at others small and contractedcl; skin hot,
and dry; entire unconsciousness, confused speech, startings and
vomiting.
Treatment.-Bellad. 400, in a wine-glass half-full of water,
one teaspoonful every hour; in six hours he was much better and
the  3ellad. was omitted.- In fifteen hours consciousness was
restored, and fever lessened; well on third day.-STAPF.
CASE 35.-A girl, aged 3 years, was attacked from taking
cold during the desquamation of scarlet fever, with:?ymnptoms. —Great restlessness, drowsiness, unconsciousness,
boring with the head in the pillow, parchment-like dryness of
the skin, with large drops of perspiration upon the face, constant rolling of the eyes, great thirst, and frequent vomiting.
Treatment.-Tinct. Bellad., one drop per dose, every hour, for
five hours; pimples broke out upon the scalp, the glands of the
neck swelled, loose stools set in, and quiet sleep, followed by
return of consciousness and great relief. Several doses of Bellad. 3, completed the cure. —F. MiiLLER.
CASE 36.-A boy, aged 3 years, was attacked with an inflammatory affection of the brain, during the period of desquamation of scarlet fever.




BELLADONNA.                      97
Symptoms.-Swelling of the parotid and cervical glands; he
lay constantly in a soporose slumber with bloated and red face;
short, rattling and groaning respiration; involuntary stools; loss
of speech and consciousness; inflammation of the mouth; thin
offensive stools; red and hot urine.
Treatment. —B ellad. 30, 20 doses, one every four or six
hours; consciousness commenced to return in twelve hours,
followed by more quiet sleep and voluntary evacuations. Profound sleep was removed by two doses of Tartar-emetic 12.GROSS.
CASE 37.-A previously healthy girl, aged 2~ years, was
attacked with vomiting, convulsions and fever; on the second
day she had the following:
Symptoms.-She lay in a soporose slumber, from which she
started up at times, grasped at her head, which was very hot;
bored with her head into the pillow; rolled her head about;
when roused she only opened her eyes one-half, stared stupidly
before her; pupils dilated, with squinting; paleness of the
face; nose pinched, dry and stopped up; lips covered with a
brown crust; skin parched and hot, with traces of a purplish
scarlet-rash; abdomen sunken; constipation for six days; involuntary urination. Her head fell back whenever it was raised
up; she uttered a peculiar cry and was very uneasy whenever
she was raised up from the horizontal position, or even moved.
Did not answer questions or pay any attention to what was
going on around her.
Treatment.-Bellad. 3, one drop four times a day; after the
first three doses violent convulsions sat in, and then the disease
gradually subsided, until the fifth day when she was quite restored.-KNORRE.
CASE 38.-A girl, aged 15 months, was attacked with fever
and stupor, and was treated allopathically for six days, when
she presented the following:
Symptoms. —She lay with closed and agglutinated eyes,
when they were opened they looked dim; constantly groaning;
heard nothing; wished for nothing, and could not speak a loud
word; tossed the left arm and leg about, and held them up in
the air; her face was pale and sunken; skin and nostrils dry;
G




98                     BELLADONNA.
breath short and quick; tongue moist; she could drink when
raised up, but let her head fall back immediately; pulse very
frequent and irritable, with a false hardness, beating more violently in the right, than in the left arm; abdomen drawn in,
and painful to touch; stools and urine were passed involuntarily.
Treatment. —Bellad. 24, one drop; in five hours frequent
greenish stools sat in, followed in twelve hours by relief, and
ability to open the eyes, although the left eye was only half
opened. On the eighth day, Chamomilla 12. was given with
transient relief, followed on the tenth day by increased restlessness, whimpering during the -attacks of diarrhoaa, tossing
off of the bed-clothes; the skin was dry and torpid; cough:spasmodic; breathing quick and short; nose reddened. Bellad. 30, 1 drop, was followed by recovery on the fourteenth day.
-MORITZ MULLER.
CASE 39.-A boy, aged 3] years, was attacked during the
period of desquamation of scarlet fever, with discharge from the
ears, and inflammation of the brain sat in when this ceased.
He was treated allopathically and left in the following condition:
Symptoms.-Restlessness; tossing about of the body; grasping at the head with the hands; paleness and shrunken state
of the face, with pinched nose; dilatation of the pupils; boring
of the head into the pillow; heat of the head; stupefaction;
brown and blackish tongue; the child desired nothing, but
drank water when it was offered; skin dry and burning hot;
pulse small and frequent; some cedema of the scalp.
Treatment. —Tinct.-Bellad., half-drop, every two hours; the
following night was very restless, but perspiration followed by
some repose ensued; boils broke out upon the scalp and back;
re-appearance of the discharge from the ear. Bellad. 3, one drop
every four hours, followed by quiet sleep, perfect restoration of,consciousness; desire for food; offensive stools; Bellad. 3,
every night and morning only, was succeeded by perfect re-:covery in ten days. —F. MULLER.
CASE 40.-A little girl, aged 21 years, previously healthy
and intelligent, had been sick for five days, notwithstanding
the use of Aconite, Pulsat., several doses of Calomel, again




BELLADONNA.?                     99
followed by Aconite. The exciting cause of the'attack was
measles with scanty and livid eruption.
Symptoms.-Stupefaction; slumber with half-opened eyes;
gritting of the teeth; starting up from sleep; whimpering, alternating with violent motions of the limbs; tossing to and fro
of the body; attempts to get out of bed; wild delirium; congestion to'the head; violent pulsation of the carotids; boring of
the head into the pillow; grasping at the head; alternating
paleness and circumscribed redness of the face; squinting;
very frequent and irregular pulse.
Treatment.-Bellad. 2, every three hours; the second dose
was followed by more quiet sleep and improvement of most of
the symptoms; on the eighth day of the disease, after a fresh
exacerbation, sweat sat in at night, and quiet sleep was followed
by gradual improvement.  She recovered entirely under the
continued use of two doses of Bellad., daily.-DIEz.
CASE 41.-Bellad. 30, in 1 drop doses acted very favorably
and promptly in a case of acute dropsy of the ventricles, attended with opisthotonos, and unconscious stupefaction in which
the patient lay part of the time as if in an apoplexy, but from
which it started up occasionally in great alarm and agony as
if from severe pain.-KAMMERER.
CASE 42. —A boy, aged 2; years, had been treated allo,
pathically without avail, but was restored in fourteen days with
Aconite and Bellad.; IHyosciamus and Veratrum  were also
somewhat useful; but repeated doses of Bellad. effected the
most good.-ScHINDLER.
CASE 43.-A girl, aged 18 months, took cold during an
attack of measles, and the eruption receded.
S'ymptoms.-Much thirst; squinting; boring of the head in
the pillow; dripping perspiration on the head; spasms, during
which the head was drawn back to the spine; she lay constantly
in a stupor with half closed eyes, and widely dilated pupils.
Treatment.-Bellad. 30; on the next day there were no
convulsions and all the other symptoms were improved; it was
soon out of danger, and recovered entirely on the fourth day.BETIMAN.




100                   BELLADONNA.
CASE 44.-A child had lain for two days in a deep stupor,
with convulsions and slow pulse; the eyes were half closed,
covered with mucus, and squinting.
Treatment.-Several doses of Bellad. 30, effected a cure in
three days.-BICKING.
CASE 45.-A boy, aged 4 years, was attacked six weeks
after having the measles with Encephal. insolationis, attended
with violent tonic and clonic cramps; pulse hard, small and
from 160 to 170.
Treatment.-Aconite 1, ten drops in water, and Bellad. 1, in
the same doses, in alternation, every half, one, or one and a
quarter hours, a teaspoonful at a time. Recovery on the fifth
day.-SCHWEICKERT, Jr.
CASE 46.-A one year old boy, had all the signs of effusion
into the ventricles.
Treatment.-Bellad. 1, in solution, one teaspoonful every two
hours, followed by Sulphur 3, and again by Bellad. A cure
was effected in four weeks, and no relapse had occurred at the
end of seven months.- IECHELHEIM.
CASE 47.-A girl, aged 5, had been sick for three days;
she neither spoke nor ate; her head was hot and drawn backwards;* pupils much dilated and insensible; pulse quick and
moderately full.
Treatment.-Bellad. 12, 3 drops in a glass of water, one
teaspoonful every two hours; the patient recovered quickly.SCHROEN.l
IN ADULTS.
CASE 48. —A powerful man, aged 30, sickened suddenly
after taking cold; on the second day he had:
Symptoms.-Sleeplessness; dizziness on attempting to sit
up; violent delirium; raging, screaming, attempting to get out
of bed, tossing off the bed clothes, and tossing to and fro; eyes
painful, reddened, intolerant of light, wild and rolling; pupils
contracted; sparks and flames before the eyes,; hearing acute
and sensitive, with roaring and tinkling sounds before the ears;
ace hot and red, although at times moist and sticky. In his




BELLADONNA.                    101
clear moments he complained of confusion in the head; of
frightful, fixed, burning, aching and piercing pains therein; he
had fits of sneezing and-of bleeding:from the-nose; his lips
were red, hot and dry; tongue red and covered with a little
tough mucus; throat contracted, with urging to swallow; disgust for food; yellow and slimy vomits; hiccough; constipation; red and hot urine; breathing anxious, sobbing and interrupted; voice hoarse and speaking difficult; pulse quick, hard
and spasmodic; skin dry, hot, red and tense.
Treatment. —Bellad. 30, 1 drop; followed by great improvement in twelve hours; on the seventh day of the disease the
patient was able to leave his bed for a short time. One dose of
Bryon. completed the cure.-SCHUBERT.
CASE 49.-A  servant girl, aged 28, after suffering with
headache for eight days, was attacked with the following:
Symptoms. — Head hot; violent pain in the forehead as if
the blood were violently forced into it; protrusion of the eyes;
frequent vomiting of greenish fluid, excited by every movement
of the head, and only abating when she was lying quietly on her
back; pulse full and slow; constipation.
Treatment.-Nux-vom. 3, was given without benefit; on the
next day the symptoms increased and unconsciousness with
quiet delirium sat in. Bellad. 1, every two hours, was followed
by gradual and steady recovery at the end of seven days.ROTHANSL.
CASE 50.-A man aged 30, was attacked after taking cold
with fever, signs of inflammation of the brain, &c.; after bleeding blistering and leeching, he was left with the following:.Symptoms.-Violent fury, he sprang up, broke the windows,
and had to be bound.
Treatment.-B ellad. 18, every quarter of an hour; followed
by improvement in a few hours; he was entirely restored at the
end of eight days.-IvANovICH.
CASE 51. —A man, aged 40, was taken with signs of arachnitis after an attack of erysipelas of the face.
S Symptoms. —His eyes stood wide open, and were dull; the
pupils dilated; nose dry; tongue with a whitish yellow coating;




102                   BELLADONNA.
thirst moderate; constipation for thirty-six hours; urine light
yellow and clear; breathing irregular, at times quick, at others
slow, now deep and anxious, and then scarcely perceptible;
pulse contracted and small, but quick and hard; at times he
could speak rationally, but always hastily; at others he would
stare horribly at one place where he seemed to see some frightful object, then would spring up from the bed, strike around him
and attempt to escape, followed by attacks of trembling and
ability to speak quietly and rationally again.
Treatment.-Bellad. 3, was followed by an aggravation for
one hour, and then immediately by improvement; on the second
day after the use of Bellad., Cocculus 6, was given on account
of the presence of pressing headache, noises in the ears, irritable, sensitive and vexatious disposition. In two days more he
was entirely restored.-RAU.
CASE 52.-Mrs. S., aged 67; particularly liable to head
attacks, for which she has been repeatedly cupped, leeched and
blistered.
Symmptoms. —Her head has not been right for the last week,
and for three days past it has grown much worse; is now confined to bed, complaining of a throbbing and hard aching pain
right through the head, from back to front; light and noise
distract her; she can get no sleep, and feels as if she would lose
her senses; sees everything double; her forehead and top of
head are burning hot to the hand; pulse hard, full and 100;
she is very thirsty; tongue foul, but moist; she had a shivering fit the day before and then vomited.
Treatment. —She had taken aperient and other medicines
and used cold applications to the head without benefit. Aconite 3, one dose, to be repeated in four hours and then followed
by Bellad. 3, every four hours; on the next day she was much
better, had no headache, her forehead was cool, she could bear
light without inconvenience, pulse soft and only 65, no nausea.
She continued the use of Bellad. and on the third day took
Pulsat. 6, and Sulphur 12, for some pain in the stomach and
slight confusion of the head. —YELDHAM.
REvIEw. —Of RiiCKERT'S 37 cases, 33 were children, viz.:
15 boys and 11 girls from the age of 13 weeks to 7 years; and




BELLADONNA.                      103
4 were adults, viz.: 3 males and 1 female from the age of 28
to 40 years.
As causes of the disease we find: taking cold in 2 cases;
suppressed measles in 1 instance; sun-stroke in 3 cases;
during measles in 1 case; after measles in 2 cases; during the
desquamation of scarlet fever in 3 cases.
The above cases prove incontestibly that Bellad. has proved
useful not only in the first but also in the second stage of hydrocephalus; it has frequently removed redness and heat of the
face, throbbing of the carotids, squinting, and also involuntary
urination.
The inflammation in two of the adult cases had reached a
great height.
Dos.- In 29 cases:
The Tincture was given in 3; viz.: 15 drops in solution in 1
case; X and 1 drop doses each in 1 case.
The 1st dilution in 4 cases, 3 times in solution.
"' 2d   "C    " 2  "I  once   "'    "
"' 3d   L"    " 5  i"  twice   ",c   and twice
in drop doses.
The 6th, 12th and 18th each in 1 case.
" 24th dilution in 2 cases.
"  30th   "    " 9  "   5 times in single doses and
4  "   " solution.
(' 400th  "    " 1  "
Hence the doses varied from the strong tincture through all
the dilutions to the highest potencies, and generally with satisfactory results; as aggravations only occurred in two instances
from the use of the 3d dilution. LOBETHAL even prefers the
pure tincture in solution to the higher dilutions.
In these 37 cases, Bellad. effected the cure alone in 21; in 6
instances, Aconite was given with advantage in alternation
every half or two hours; Tarto-emet. was given in 1 case after
Bellad. to remove drowsiness; in 1 case Sulphur was given
between two doses of Bellad; and Cocculus in 1 case to remove
a remaining peculiarly irritable state of mind.
In the first stage of dropsy of the brain Belladonna generally
removed all danger in twenty-four hours; in 5 cases, however,




104                   BRYONIA-ALBA.
from two to six days were required. In the second stage, three,
four, five or even fourteen days were required, and in one case
even four weeks.  In adults from  five to eight days were
necessary.
B RY  N I A- A L B A.
The root which is the only part used in medicine bears a
sufficient resemblance to a thick turnip to have given rise to
very alarming mistakes; hence, it has received the common
name Devil's turnip. Some French peasants use it fresh as a
purgative. Allopathic physicians look upon it as a drastic purgative and as a substitute for Colocynth, Elaterium, &c. Towards the end of the last century, Dr. DE MONTGAMY fancied
that Bryonia contained all the therapeutic properties of Ipecac.
and proposed its substitution.  In all probability it is very
similar in its action to Colchicum, Helleborus-niger, and Veratrum-album. At least it acts decidedly upon the stomach, liver
and bowels, also upon the serous and fibrous tissues, and probably upon the kidneys.
It has principally been used against rheumatism; mild typhus fever, which commences with pains in the limbs and bones;
against inflammatory swelling of the joints, cedema of the legs
and pleurisy; the ancients often employed it internally against;
dropsy, and more particularly in hydrothorax, of which it must
have effected many cures. DE MONTGAMY says he has frequently cured bilious fevers, vomiting, colic, diarrhoea and dysentery
with it; hence TESTE terms it an emetic which cures vomiting
and a drastic which stops diarrhoea and colic. HAHNEMANN
probably got the hint for its use against pleurisy, from the
ancient use of it against hydrothorax. KASPAR says it is homeeopathic to infiltrations into the cellular tissue and serous effusions into the serous cavities; but not to plastic and fibrinous
exudations. In dropsy of the head, chest, &c., if small doses
do not suffice, it may be allowable to use it in large doses after
the manner of the ancients in these diseases, in fact, so as to
produce a decided action upon the liver, bowels and kidneys.PETERS.
According to the Oestreichische Zeitschrift, the pathological




BRYONIA-ALBA.                   105
appearances produced by Bryonia, together with the symptomatic phenomena, point to congestion and inflammation of the
brain.
According to KREUSSLER, Bryonia is indicated when there
is great restlessness, tossing about in bed, especially at night,
troublesome and frightful dreams, extremely irritable state of
mind, heat of the head, greater redness of the cheeks than of
the rest of the face, violent and piercing pains in the head,
nausea and constipation. He prefers the 12th or 18th dilutions,
repeated twice a day.
According to WAHLE it often happens that Aconite and Belladonna, even when given in the first stage, will not prevent
effusion and exudation. Then Bryonia will often effect wonders
when the face is very red or almost mahogany colored, the eyes
rolling about, at times closed and at others wide open, the lips
dry, tongue dry and brownish yellow, abdomen distended, bowels
constipated, urine suppressed or sharp and burning, skin of the
whole body dry and hot, breathing quick, anxious and groaning,
thirst excessive and urgent.
He prefers a few globules of the 30th dilution. If Bryonia
be given too late, which may easily happen, as the first occurrence of effusion is often overlooked, so that a cure is not effected in twelve or twenty-four hours, then some other remedy
must be resorted to.
CASE 53.-A powerful man after lying drunken in the
snow for six hours, had the following:
Symptoms. —Heat and redness of the head and face; great
thirst, chilliness, constant inclination to sleep, starting up in
affright, screaming out, delirium, complains of frightful images
before his sight, frightful dreams, cold sweat on the forehead,
pains in the head and limbs.
Treatment.-Tinct.-Bryonia in one drop doses; followed by
an aggravation in two hours; after this he drank water freely,
broke out into a profuse and offensive perspiration, so that he
had to change his shirt five times in fifteen hours, and was
completely restored in several days. —SCHULLER.




106                  BRYONIA-ALBA.
CASE 54.-A youth, aged 18, had suffered with a discharge
from the ear, which became suppressed by cold.
Symznptoms.-Violent piercing and insupportable pains darting from one ear to the other through the head; high fever,
intolerance of light with very moveable pupils, sleeplessness or
starting up from slumber, violent cough with pain in the forehead; constipation.
Treatment.-Bryonia 2, one-sixth of a drop every two hours;
at the end of twenty-four hours the discharge from the ear had
returned, he had profuse perspiration especially upon the head,
the pain and fever were but slight, the skin only moderately
warm, thirst not urgent, but he Moas restless, tossed about,
thought he was going to die, slumbered a good deal, and had an
involuntary discharge of mucus from the bowels. Hyosciamus
2d dilution, followed by the 1st, removed all danger in three
days, and the patient was well in six.- SEGIN.
CASE 55.-A man, aged 37, of nervous-venous constitution
and afficted with piles, had had inflammation of the brain three
years before, and was attacked with acute arachnitis fourteen
days after the suppression of the hbemorrhoidal flow.
Synzptoms.-Restless sleep, typhoid delirium with spasmodic
twitchings of the fingers, constant thirst, redness of the face,
heat of the head, jerking of the hands, contraction of the abdomen, with sensitiveness to pressure, profuse perspiration, pulse
large soft and quick, 100 per minute; if spoken to sharply he
started up, answered yes or no in broken tones, then fell into a
slumber again, but complained of violent pains in the head, his
eyes closed spasmodically, pupils were contracted, tongue moist
and broad.
Treatment.-Bellad. 4, one drop every two hours; in two
days there was some improvement, he could speak more connectedly, his urine commenced to deposit a sediment, but his
pulse remained frequent and quick and he soon relapsed; violent drawing and beating pains shot from one temple to the
other, and his pulse became quicker, smaller and harder. Bryonia 2, was then given, one drop every two hours the first day,
every three hours on the second, and night and morning on the
third day, with progressive improvement; the patient only complained of a sense of fluctuation in the head, with slight dizzi



CUPRUM.                      107
ness when he sat up, and some pain in the right temple. A fit
of vexation caused a fresh relapse which was quickly cured by
Bellad. 4, one drop every two hours. —NoAcK.
REVIEW. —The above 3 cases all occurred in adult males;
2 cases were in the first stage, and in the other the presence of
effusion was feared. In every case Bryonia was the decisive
remedy; in one instance it effected a cure alone; in one case
Hyosciamus had to be used; and in the other, Bellad. had been
used with only transient benefit.
Taking cold was the exciting cause in two cases; while suppression of an ear and hmamorrhoidal discharge complicated the
others.
WAHLE'X exact indications for the use of Bryonia are very
important; he lays stress upon the presence of a red, almost
mahogany-color of the face, while KREUSSLER prefers redness
of the cheeks, rather than of the whole face as an indication;
the violent pains from the ears and temples through the head
were well marked in one case.
DosE.-The curative doses were the 1st and 2d dilutions;
although KREUSSLER prefers the 12th or 18th dilution, and
WAHLE the 30th, from notional and theoretical grounds.
CUPRUM.
Cuprum is homceopathic when there is a febrile-inflammnatory
affection, attended with quite severe pain in the forehead, with
paleness and sunkenness of the face, warmth and dryness of the
skin and some quickness of the pulse.
Also when there is a remitting or mild typhoid-like form of
fever, with great weakness and lassitude of the limbs, vertigo,
heaviness in the head and headache, pains in the stomach and
bowels and constipation. Also, when the patient is so dizzy
that he cannot sit up, with occasional headache, restless sleep
disturbed by dreams, slight delirium, or constant slumber, which
may increase to perfect coma; or there may be entire sleeplessness, with paleness of the face, with expression of extreme
prostration or entire stupidity, the eyes being sunken and dull,
and the pupils dilated. Or there may be a sensation of utter




108                     CUPRUM.
exhaustion and lassitude, which may be increased to the point
of fainting, from slight exertion. The tongue may be red at
the edges, or red, dry and rough with enlargement of the -papillae; the thirst great, appetite extinct, with disgust for food,
skin warm and moist; pulse quick; urine turbid and jumentous. If these symptoms pass off, vertigo and confusion of the
head will remain, with long-continued and obstinate weakness
and lassitude.
When there is frequent and violent vomiting, or persistent
nausea. The pulse may be full, hard and frequent, or weak and
slow.
In almost all copper-cases there will be headache, at times
violent and generally seated in the forehead and vertex; this
headache may abate in a few days to return again. In the
milder cases there will only be aching and heaviness in the
head, with decided and obstinate dizziness, and a certain amount
of stupefaction. In the majority of cases the patient will lie
still and apathetic, with dull and unexpressive eyes, stupid and
relaxed expression of countenance and great inclination to slumber, but the sleep will be disturbed by dreams, restless and not
refreshing. In some there will be a well-marked soporose condition; in others, entire sleeplessness for three or four days,
attended with a feeling of internal restlessness and anxiety.
Actual delirium occurred only 7 times out of 38, and generally
was of the quiet kind, interrupted by mutterings and occasional
groans.  In one case furious delirium  was present.  In all
cases loud speaking to them would break up their delirium, but
they were obliged to collect themselves for a long time before
they could answer questions.
There may be darkness or flimmering and sparks before the
eyes; the pupils are generally and widely dilated, but not insensible to light; but when the congestion to the head is very
great the pupils may be contracted.
In the ears there may be roaring and tinkling in many cases,
and long-continued deafness.-LANGENBECK.
Cuprum is supposed to be peculiarly homceopathic when
there is vomiting of greenish substances, followed by copious,
green, offensive and liquid stools. Hence in'the brain-affections
which follow cholera infantum.




CUPRUM.                        109
It proved homceopathic in one case in which there was colic
and anxiety, great rigidity of the body, coldness of the hands,
swelling and redness of the face with great drops of perspiration upon it, eyes fixed and dull, tongue swollen and stiff, pulse
full and hard, breathing short and heavy, followed by oppression
of the chest, throbbing and roaring in the head, surprising dulness of the intellect, so that everything which the patient said
was erroneous.
It proved honceopathic to severe pain in the stomach, -followed by violent convulsions, especially affecting the abdomen,
arms and legs, attended with frightful and violent cries, or
howling or croaking, also with disturbance of the intellect, appearance of fright and attempts to escape; the eyes were brilliant and seemed as if they would start out of the head. Also
to severe vomiting, violent cramps in both of the great toes
which were drawn tetanically towards the soles of the feet, with
excessive pain.
According to CHRISTISON and ORFILA it is homoeopathic to
insensibility, almost always to convulsions, to rigidity of the
body and even tetanus; also to violent convulsions and insensibility.  According to BLAKE, however, the salts of copper
when injected into the blood-vessels act with peculiar force in
exhausting muscular irritability and paralyzing the heart; the
force of the heart's contractions are speedily reduced, allowing
of distension of the heart from loss of contractility. It is also
homoeopathic to vomiting, difficulty of breathing and stiffness of
the limbs. It is peculiarly homoeopathic to violent headache,
vomiting, cutting pains in the bowels, followed by cramps in the
legs, and pains in the thighs, especially if associated with
bilious derangement and jaundice; also to severe headache, with
great prostration of strength.
It is indicated when there is insensibility, with the jaws
locked, muscles rigid and frequently convulsed, breathing interrupted and pulse small and slow; or by convulsions and loss
of consciousness, followed by extraordinary paralytic weakness
of the arms and legs, especially if there be pains the stomach,
an eruption over the breast, general shooting pains, thirst, frequent small pulse, vomiting, hiccough and purging.
Copper, or more especially BRASS, is hom~copathic to irrita



110                      CUPRUM.
tion about the genitals, a vesicular eruption about the hairs on
the pubes, with loss of appetite, tendency to vomiting, obstinate
constipation, soreness and dryness of the throat and irritation
of the nose, and great want of sleep.
Among the pathological lesions it is homceopathic to Jaundice, congestion of the surface of the brain, perforation of the
bowels by ulceration; especially of the rectum.-PETERs.
Concerning the adaptation of this remedy in inflammatory
diseases of the brain, we find only a general remark, and one
case where it had been given and then in frequent alternation
with Stramon. and Bellad., so that in regard to Cuprum and its
influence little is to be learned; it requires further examination
by practitioners.-RiiCKERT.
GENERAL REMARKS.-SCHMID has alluded to a particular
kind of affection of the brain, developing itself in children
during febrile catarrh, difficult dentition, and eruptive diseases,
which finds its remedy in Cupruin-acet.  The following are
characteristic:
Symptomns.-The little patients have a surly, very irritable
temper, or are indifferent and feeble, with restless sleep, tossing about in the same, are sleepy, without being able to sleep;
unable to hold their heads up while awake; dryness of the
mouth, disgust for food, nausea, vomiting, constipation, scanty
urine; chilliness accompanied by heat; heat, generally slight,
but at times burning; pulse very changeable, moderately full
and irritated, with evening exacerbations; convulsions, gritting
of the teeth.
Bell. does not afford relief; the exacerbations may be moderated by Aconite; but Cuprum acet. is the most reliable remedy.
-Hlyg. 12, 2, 116.
CASE 55.-R., a large-headed, robust boy, 4 years of age,
formerly atrophical, was attacked on the evening of the 30th of
June, with general convulsions.
Treatment.-Acon. 1, and Bell. 1, aided by sponging the
head with cold water. At nine o'clock in the evening he had
the following:
Symptoms. —The burning heat existing before sponging
with cold water was changed to a moderate temperature of




CUPRUM.                       111
the skin; pulse quick, hard, almost uncountable.  General convulsions of the limbs from time to time; on the left side the
spasms were more clonic, on the right more tonic; spasmodic
convulsive movements of the muscles of the face; eyes mostly
open and staring, but at times closed by the convulsion of the
muscles of the face, attended with squinting. The pupils were
fully dilated and insensible to light. Lower jaw tightly pressed
against the upper one, with gnashing of the teeth. Respiration
very heavy, accompanied by rattling in the chest, and intermitting at times for eight to ten seconds, as in the dying. Palsy
of the lungs was momentarily expected.
Prescription and Result.-Cuprum-acet. 1, 1 gr. per dose,
dry upon the tongue, followed in ten minutes after by Tinct.
Stram. 1, and cold applications to the head.
After the second dose of each medicine an intermission of the
convulsions was followed by coldness and relaxation of the limbs
and apparent cessation of the respiration, so that paralysis of
the nerv. vag. seemed imminent.  Phosph. Tinct. was then
given; some contraction of the pupils was soon observed, and
the Phosphor. was continued after the lapse of a quarter of an
hour, in alternation with Cuprum and Stram. At twelve o'clock
at night there was an important intermission of convulsions, but
frightful reaction of the blood-vessels, the face and body became
glowing hot and dark red, the carotids throbbed violently, the
eyes were decidedly injected and the pupils contracted. The
child was conscious and screamed when sprinkled with cold
water.
Cupr. S., 2 gr. per dose, in alternation with 10 drops Bell.
(in solution.) On the following morning the little patient was
sitting up and playing in the bed, his pulse was still 120, but the
hardness was diminished, and his eyes yet somewhat staring.Both remedies were continued till the 3d of July, when the boy
was dismissed cured. —ScHwEIcKERT.
D I GITA L I S -P UR P.
This remedy has long enjoyed a high reputation against many
dropsical affections, and also in dropsy of the brain. According
to WARING it has been found serviceable by WITHERING,




112                  DIGITALIS-PURPo
BROWN, WHYTE, CHEYNE and GbLIs. The latter however,
without appearing to place much faith in its efficacy, advises
gr. 3 of the pounded leaves, with gr. - of Calomel, every second
hour. He gave it, both in the inflammatory stage, and in that
of effusion; in the latter, chiefly as a palliative, to moderate the
violence of the convulsions. KLEBER advises its external application, in combination with Squills to the scalp. MERRIMAN
treated cases successfully with Digitalis and Calomel as advised
by GOLIS. Of 92 cases of dropsy of all kinds collected by
BAYLE, 65 are said to have been cured by Digitalis, 15 improved and 11 not cured. WITHERING, of 126 cases, in the last
stages of dropsy, cured 48 with Digitalis alone; FERRIA Of 20
cases, cured 8 perfectly, improved 8 materially, and only failed
entirely in 4 cases; JONES Of 24 cases cured 15 perfectly, improved 4, and saw no good effects in 5 cases only; in 7 other
cases out of 12 of ascites, it acted as a diuretic; also in 6 cases
out of 15 of hydrothorax. Hence we may agree with PEREIRA,
who says, of all the remedies for dropsy, none have gained more
and few so much celebrity as Digitalis.
We propose next to inquire whether it has been found most
useful in inflammatory or dyscratic dropsies. It is a decidedly
antipathic remedy to fever and inflammation, as in full doses its
most ordinary effects are: nausea or actual vomiting, slow and
often irregular pulse, coldness of the limbs, fainting, or a tendency to it, giddiness and confusion of vision. Yet WARING
says, experience has shown that although it exercises a powerfully depressing action upon the heart, it possesses little or no
power in controlling inflammatory action. PEREIRA says that
in violent and acute inflammation accompanied with great excitement of the general circulation, especially in plethoric subjects,
Digitalis is in some cases hurtful; in others it is a trivial and
unimportant remedy, and fox-glove if serviceable at all, can
only be used successfully after other and more powerful antiphlogistic measures. Again, he says: inflammation of a chronic
kind may be going on in one part of the body, to an extent
sufficient to produce complete disorganization, and ultimately to
cause the death of the patient without the action of the larger
arteries or vascular system  generally being remarkably increased; in such cases Digitalis is for the most part of little




DIGITALIS-PURP.                  113
use. Finally, PEREIRA decrees that as a remedy for inflammation, -fox-glove is principally useful in less violent cases,
particularly when accompanied with increased frequency of the
pulse, and occurring in subjects not able to support copious
blood-letting. Still he admits that it has some influence over
inflammation of the arachnoid, and is certainly a most valuable
agent in arachnitis of children; while its specific influence over
the brain would make it a doubtful remedy in phrenitis.
There is one stage of dropsy of the brain in which it is peculiarly homceopathic.  In the second stage, the pulse becomes
slow, labored, intermitting and irregular, but is easily quickened
by motion or mental disturbance to double its previous amount
of pulsations; in this stage the pulse falls from 120 or 140, to
80, or even as low as 54, and this is the time in which Digitalis
is peculiarly homoeopathic; if rightly given it may prevent the
second quickening of the pulse, or at least prevent it from
rising again to 140 or 160, which it is very apt to do. Dr.
BAILDON first noticed the effect of posture in ascertaining the
real effects of Digitalis on the pulse; when by gradually increased doses, he took it to the extent of gr. vj. in the day, the
pulse fell from 110 to 40; when it was actually 40, the erect
posture would raise it to 100; when sitting it was 72; and on
again lying down it fell to 40. Digitalis acts specifically upon
the par-vagum, and the slowness of the breathing and pulse in
the second stage of dropsy of the brain, is produced by pressure
upon this nerve at the base of the brain.
PEREIRA and HOLLAND have both observed several times in
patients affected with a slow, intermittent and otherwise irregular pulse, that Digitalis would produce regularity of pulsation.
If it will remove the symptom it may also remove the cause
upon which the symptom depends; besides, Digitalis produces
absorption and acts profusely upon the kidneys, and hence may
remove the slow pulse of hydrocephalus, by producing absorption of the dropsical effusion. It is not advisable to use Digitalis in the first stage, if for no other reason than that given: by
HoPE, who says in no disease do the symptoms more require
to be kept, as far as practicable in a simple, uncomplicated, and
intelligible state, and no remedy is so calculated to confuse
them as Digitalis. The reduction of the pulse which it occa



114                  DIGITALIS-PURP.
sions cannot be discriminated with any degree of certainty, from
that occasioned by the supervention of pressure in the second
stage; again, Digitalis is apt to produce vertigo, faintness and
nausea, and how, asks Dr. HOPE, are these symptoms artificially excited, to be distinguished from the same results of
inflammation and dropsy of the brain? Easily, by not using
Digitalis at all, during the first or inflammatory stage; but by
giving it boldly and perseveringly in the second or dropsical stage.
PEREIRA says the quantity of Digitalis that may be given to a
patient without destroying life, is much greater than is ordinarily imagined. In one instance he saw 20 drops of the tincture
given to an infant laboring under hydrocephalus, three times
daily forla fortnight, at the end of which time the little patient
was completely recovered without one untoward symptom. I
do not propose that Digitalis should always be given in such
large doses; but if smaller ones will not suffice, larger ones
should be made to do the work, and effect the cures they have
accomplished before. It is exceedingly doubtful whether Digitalis can be given usefully during the first or inflammatory
stage; WITHERING hlas correctly observed that it seldom succeeds in dropsical persons of great natural strength. of tense
fibre, of warm skin, of florid complexion, or in those with a tight
and cordy pulse; on the contrary, he says, experience teaches
that if the pulse be feeble or intermitting, the countenance pale,
the lips livid, and the skin cold, we may expect the diuretic
effects to follow in a kindly manner. In short, when nature or
disease brings the pulse and general system into that condition
which is most peculiarly apt to be produced by Digitalis, then
the other and curative effects of the drug may be expected to
follow promptly and from moderate doses.
It is surprising how frequently a symptomatic similarity
between the action of a drug and of a disease, affords a hint for
the selection of a curative remedy. Thus the principal diseases
of the valves of the heart are contraction and patency of the
Aortic valves and of the Mitral. The slighter degrees of contraction of the Aortic valves have little or no effect upon the
pulse, which will remain firm and full as long as the contraction
of the valves is not so great as to prevent the left ventricle from
emptying'itself; again, Aortic-regurgitation produces a pre



DIGITALIS-PURP.                  115
eminently jerking pulse, for the beat of the artery is short and
quick, as if the blood were smartly jerked or shot under the
finger. Hence the homoeopathist would conclude from the pulse
alone, that Digitalis will rarely prove useful in diseases of the
Aortic valves, and old school experience has already shown that
it is rarely useful when the pulse is hard, tight or corded.-But
when the Mitral valve is contracted, and also when it admits of
free regurgitation, the pulse is in various degrees small, weak,
irregular, intermitting and unequal, i. e. the pulse resembles
that produced by Digitalis. From the pulse alone the homceopathist would conclude that Digitalis ought to prove useful if
not curative, in diseases of the Mitral valve. What does experience teach on this point? CORRIGAN was the first to allude
to the injurious effects of Digitalis in diseases of the Aortic
valves, while he found the most favorable results to follow its
use in affections of the Mitral valves. In patency, admitting of
regurgitation through the Aortic valves, the less frequently the
heart beats, the greater will be the opportunity for regurgitation, and hence the prolonged employment of Digitalis, so as to
lessen the frequency and force of the heart's action, cannot fail
to be injurious.  On the other hand in contraction of the Mitral
valve, the lengthened interval between the contractions of the
heart, produced by Digitalis, permits the left ventricle to become
more fully distended, while it also lessens the frequency of the
interruptions to the passage of the blood, and hence the pulse
becomes fuller, stronger, and more regular. Again, in patency
of the Mitral valve, Digitalis prevents the regurgitation from
being so frequently repeated.
Slowness and intermittence of the pulse in the second stage
of hydrocephalus, are probably as safe guides for the use of
Digitalis as they are in disease of the Mitral valve; at least as
Digitalis does not generally exert its absorbent and diuretic
action until it has lowered the pulse and reduced the system, it
will of course be more apt to produce absorption of the hydrocephalic fluid, when the pulse has already become slow, weak
and irregular or intermitting from  the effects of disease.PETERS.
In conclusion, Digitalis has long retained a reputation against
scrofulous affections, ani hence it may be suitable in scrofulous




116                  DIGITALIS-PURP.
meningitis. VOGT says: next to its diuretic action it exerts a
decidedlypowerful action upon the lymphatic glands and the
whole lymphatic system.  From  its great curative powers
against scrofula we can conclude that it fluidizes the lymph,
facilitates its circulation, and removes obstructions of it.  Next
to the vascular, urinary and lymphatic systems it acts especially upon the serous membranes. In the second degree of the
action of Digitalis, pains are often felt in the lymphatic glands,
and also a very abundant flow of saliva; hence it also acts upon
the salivary glands, and perhaps upon the pancreas. —VOGT.
Digitalis may prove to be one of the most homceopathic
remedies against sick-headache, especially in that variety which
is attended with disturbance of the urinary secretion. Even in
small doses it causes headache especially in the temples and
back of the head; decided disturbance of vision, such as clouds,
sparks, flimmering or colors before the eyes, with sensitiveness
to light; also paleness and coolness of the skin, weakness of
the pulse, general prostration, nausea and vomiting; with a
peculiar disturbance of the urinary organs.  Many persons,
subject to sick-headaches, will have their urine clear and abundant when they are well; when the headaches occur frequently
and severely their urine is apt to be thick and dark, like coffee
or brandy, with more or less brick-dust, or other sediment.
When the headache comes on, the urine will again become clear,
and be like spring-water and abundant; when the headache is
going off, the urine becomes thick and dark. In another class
of headaches the urine acts entirely differently, being scanty and
irritating during the headache, and becoming clear and abundant
when the headache passes off. In one or both of these forms of
headache, Digitalis will prove useful. It would seem that many
headaches arise from derangement of the kidneys and retention
of urea, or some other effete substance in the blood.-PETERS.
CASE 56.-A little girl, 2 years of age, blond, of delicate
constitution, and merry disposition, fell into the second stage of
hydrocephalus, with the following:
Symptoms. —Head hot, falling backwards on lifting up the
child; sleep-like condition, with half-opened eyes and widely
dilated pupils; look staring, with squinting; dulness and rolling




HELLEBORUS-NIGER.                  117
of the eyes; convulsions of the muscles of the face; great
thirst, constipation; urine scanty, leaving on the chamber a
glossy, glimmer-like deposit; skin, sometimes hot and dry,
sometimes cold and covered with sweat; pulse irregular, weak
and soft; convulsions of the limbs during sleep; piercing cries.
Treatment.-Bell. 9. in water, four hourly; the first and
second day without result, afterwards Digit. 3., also four hourly.
The following day improved consciousness, increased flow of
urine; soft, slimy stools, followed by green, looser, more slimy
passages, preceded each time by crying, drawing up of the legs,
screaming and convulsions of the limbs. After three days' use
of the Digitalis, Cham. 3. was given, followed by sleep for five
or six hours, from which she awoke conscious, with appetite,
natural expression, pulse more regular and stronger.  Still
some Sb. Cham. 3. On the twentieth day of the treatment the
recovered child went into the fresh air.-Y. 95.
E L L E BO R U S - N I GE R.
GENERAL REMARKS.-According to VOGT and PEREIRA in
small doses it acts as a mild stimulant to the stomach, bowels and
abdominal nerves, also quite especially upon the pelvic nerves
and those of the rectum and genital organs; in short, it is a
powerful alterative remedy for the abdominal nervous system.
In somewhat larger doses it increases the secretions from the
stomach, and causes the excretion of a larger quantity of fluid
bile; it arouses the circulation in the portal system, and in the
liver and spleen.  It acts less powerfully upon the abdominal
lymphatic system, and very little if at all upon the kidneys.
Next to its action upon the abdominal nervous system, its effects
upon the skin are most decided.
It is much more apt to excite vomiting in large doses than
purging, and EMMERT found it more apt to excite vomiting
when injected into the veins, than any other drug. In excessive doses it causes most violent vomiting and purging.
It is one of the oldest medicines used in the practice of medicine. Thus, about the year 1500 before the Christian era, a
certain Melampus, son of Armithaon, a most celebrated augur




118                HELLEBORUS-NIGER.
and physician, is said to have cured the daughters of Proctus,
king of the Argivans, who in consequence of remaining unmarried were seized with an amorous furor and a wandering
mania. They were cured by means of Hiellebore given in the
milk of goats. From this circumstance the great fame of this
plant is derived. In the course of time the use of Hellebore
became so frequent, that every year a large concourse of patients flocked to Anticyra, where this plant grew in great abundance and perfection, in order to be cured with it of mania,
melancholy and other mental affections. At first it was thought
to be especially useful in cases with derangement of the pelvic
organs, and even in later times it was greatly esteemed by
MEAD as an emmenagogue, and is still much valued by some
practitioners. He gave two teaspoonsful of the tincture in a
glass of warm water, twice a day.
But soon it was conjectured that Black Hellebore possessed
the power of carrying off black bile easily and promptly, and
hence its use was extended to liver and spleen diseases, and
such cases of epilepsy, mania and melancholy as were supposed
to proceed from the presence of black bile.
Finally it was regarded as simply an evacuant remedy, and
given against dropsy, jaundice, suppressed menses and hoemorrhoids, worms, obstinate eruptions, chronic gout and rheumatism, and fever and ague. And against diseases arising from
the suppression of eruptions, or accustomed haemorrhagies.
HAIHNEMANN says: if it is used for a long time it will cause
severe headaches and a fever; hence he infers its usefulness
against chronic headaches, mental affections, quartan fevers and
dropsy, as proven by old school experience, i. e., because a remedy which acts upon the head and causes headache, it may cure
mental affections homoeopathically; a remedy which simply
causes fever, may cure quartan fever homceopathically; and last
of all dropsy, because the worst kinds of dropsy are always accompanied by remitting fever-certainly never have such wholesale assumptions been made from such slight premises; yet
such overstrained attempts to fasten a homoeopathic explanation
upon allopathic cures are not at all uncommon with HAHNEMANN.-See Lesser Writings, p. 292.
a. BREDENOLL says; since I have been a homeopathic




HELLEBORUS-NIGER.                  119
physician, (fifteen years,) I have frequently treated patients,
suffering with hydroceph. acut., and have cured at least twelve.
The principal remedy is and remains Helleb. I never have
seen any result from Bryon. and Sulph. if I abandoned Helleb.
-N. Arch. 3, 3, 46.
b. WAHLE SayS; if the first stage of effusion has already
begun, and Bryon. was not given at the proper time, so as to
effect a cure in the course of twelve to twenty-four hours, and
there appeared during an intermission of the fever, the wellknown symptoms of effusion, such as heavy breathing, unconsciousness, trembling, and putting of the hands to the head,
squinting, indifference to light, chewing motions of the mouth,
sopor, then one dose of Helleb.-nig. 30. will often remove all
danger in the course of a few hours.-Arch. 15, 2, 23.
CASE 57.-A boy, 2r years of age, was treated for inflammation of the brain, for fourteen days with Mercur., Moschus,
leeches, &c. On the 31st of July he was in the following condition:
Symptoms. —He had lain for six days in a soporific state;
the eyes could only be half-opened; eye-lids were stuck together
and dry; the eye-balls reddish, glassy and turned upwards;
the pupils dilated; no sign of consciousness; face pale and
disfigured; head hanging down behind; pulse, weak, quick and
irregular.
Prescription. —Hell. 3. a few drops in a wine-glass of water,
a teaspoonful to be taken every half-hour.
On the 2d of August there were signs of consciousness; the
eyes were less fixed; he commenced to take food; on the 3d of
August, state improving in general, but there were frequent
convulsions of the right arm, convulsive pain in the limbs, and
sudden starting up from sleep. Hyosc. 3. and Helleb. in alternation till the 8th, with continual improvement. Then he was
conscious and without fever, still the convulsive movements had
abated but little, saliva accumulated in the mouth, his speech
was indistinct, voice groaning, he coughed at night, with severe
vomiting. Bell. was given morning and evening, one drop per
dose for four days, when the recovery was complete.-ELwERT.




120                HELLEBORUS-NIGER.
CASE 58.-A little girl, 21 years of age, sickened with all
the signs of disease of the brain, and the following symptoms
were present on the sixteenth day of her illness:
S:ymptoms.-She has been lying for a week upon her back,
apparently in slumber, her eyes only half-shut, pupils contracted, cornea and albuginea dim as if covered with dust; in
the c~oners of the lids dry mucus, squinting, eyes turned inwards, sunken and surrounded by blue circles; face pale and
thin, nose pinched; nostrils covered with sordes; lips chapped
and dry; body emaciated, covered with loose, harsh skin. The
pit of the stomach drawn in, legs extended, the legs were drawn
up to the thighs at every attempt to change the posture.Groaning; painful, lamentable crying; face distorted by pain;
the head fell back involuntarily; eyes wide opened, with enlarged
pupils; oscillationof the iris; access to light, speaking and calling did not arouse the patient. He drank largely, biting violently at the spoon, without arousing from his unconscious state;
distortion of the face, chewing with the mouth; grasped with
the hands at his head, had cramps in the dorsal muscles, gritting of the teeth, constipation, involuntary urination, partial
sweat on the scalp; pulse quick, weak and intermitting.
Prescription.-Tinct. Hlelleb.-nig. Gtt. ij., to be taken every
two hours, day and night, for six days, finally every three to six
hours.
On the third day the brilliancy of the eyes had returned, he
cried out seldom, -gave attention to objects, and from the sixth
day of the treatment, the improvement advanced so rapidly
that no other remedy was required.-Allg. Hom. Ztg. 19, 39.KNORRE.
CASE  59.-A  boy, aged 6 years, had been drooping for
some time, and finally got all the symptoms of brain-disease,
attended with gastric derangement; he lay doubled up in bed,
with his knees drawn up to his stomach, and could not bear his
abdomen to be touched-; he was very drowsy and heavy, and
when-not disturbed, remained constantly in a stupor with halfclosed eyes and open mouth; when roused, and also at other
times, he started up and screamed out with loud piercing cries;
his features were sharp and sunken; his mouth and nostrils
sore, dry and black; his tongue dry and parched, also thickly




HELLEBORUS-NIGER.                  121
coated brown and yellow, the edges and papillae being of a deep
red color; the skin of the whole body, but more particularly of the
head and bowels, was dry and hot; he was thirsty and had no
appetite; bowels loose and evacuations unhealthy; pulse. 125,
and hard; he was also harassed by a short, hacking cough.
Treatment.-Arsenicum 6., every four hours; at the end of
two days he was much the samen except that the tongue appeared somewhat clearer, and he was not so thirsty; continue
Arsen. 6., every four hours; in three days more there were
only some shades of amendment. Then Hellebore 6. was given
every four hours, and in two days there was a decided improvement, and in a few days more he was perfectly restored.YEL DHAM.
CASE 60.-A boy, aged 3 years, was taken sick three or
four days ago, with disordered bowels, and soon fell into a
drowsy and heavy state, in which he hangs back on his mother's
arm, shewing the greatest repugnance to being moved or disturbed; his brow was knit and frowning; his eye-lids drooping,
pupils contracted, eyes dull and unexpressive; his head as well
as body generally hot and dry; breathing short and quick,
pulse 160 and throbbing; was very thirsty, could not bear the
least noise and avoided the light; his tongue was white and
thickly coated; bowels loose; he was exceedingly weak, and had
commenced to emaciate.
Treatment.- Aconite 12. and Bellad. 12. in alternation every
four hours;- the next night he was quite delirious, but much improved in the morning, his skin was cool, pulse only 100, thirst
less, eyes still heavy and frowning; omit Aeon. and continue
Bellad.; on the next day there was an increase of stupor, but
his skin was still cool and pulse laboring; gave Hellebore 6.
every four hours with marked improvement in twenty-four hours
and rapid recovery.-YELDHAM.
CASE 61.-A girl, aged 7, had been failing for some time;
bowels relaxed and passages unhealthy.
Treatment. Mercurius 6., three times a day-; in two days
was considerably worse, stupid, heavy and lethargic; started
and screamed; her head was hot, and she was feverish and
thirsty; her tongue coated brown and dry. Bellad. 6., every




122                    HYOSCIAMUS.
four hours; at the end of three days more she was still worse,
was perfectly lethargic and unconscious of everything; she
screamed and started terribly, and rolled her head; her lips,
tongue and teeth were black and dry, and covered with a thick,
hard and offensive matter; pulse very rapid, and skin and head
very hot. Then took Hellebore 12. and Rhus. 12., every four
hours in alternation, with decided improvement at the end of
two days, when her lips and tongue were moist and cleaning,
mind more quiet and intelligent, no more screaming.  The
medicines were continued for five days more, when she was
quite restored.
HYOSCIAMUS.
The most marked effects observed by GREDING were:
1. Perspiration. Seven patients out of forty had a profuse
dripping perspiration on the first night; and two-thirds of all
the others had more or less sweat; they perspired not only in
summer, but also in the fall and winter; the perspirations were
sour at times.
2. Sleep. A quiet, refreshing and deep sleep, generally attended with breaking out of the perspiration; many patients
slept the first night, but more, viz.: twenty out of forty, slept
better afterwards.
3. Happiness of mind, activity of body, and greater clearness
of intellect; fourteen out of forty patients experienced the former, and nine the latter.
4. Dulness and heaviness of the head occurred in four cases.
5. Headache in fifteen cases.
6. Dizziness in eight cases.
7. Torpor of mind in three cases.
8. Eruptions occurred in five cases, viz.: brown spots. or
liver-spots, small pustules, boils, and also swelling of the left
parotid gland.
9. Profuse urination occurred in three cases, on the first day;
and finally in at least one-third of all the cases.
10. Diarrhoea more or less profuse and continuous occurred
in twenty-three cases; with expulsion of worms in three cases;




IYOSCIAMUS.                     123
with vomiting of bile and mucus in ten cases; with colic and
rumbling in six cases; with nausea in five cases. Constipation
only took place in two cases, and then only in a slight degree.
11. Menstruation was brought on, or increased in twelve
cases; in one case it was brought on after a suppression of five
months.
12. Salivation occurred in one case.
13. Profuse catarrh in one case.
14. Rheumatic pains in seven cases.
15. Dry, convulsive cough in two cases.
16. Hiccough in three cases, in one with involuntary urination.
In one case, in an adult woman, an overdose of the Root produced, slight and then increased stupefaction; flimmering before the eyes, brilliancy of the eyes, double vision; considerable
dilatation of the pupils; dimness of sight; dizziness; great
dryness of the mouth; trembling of the limbs and staggering;
small, scarcely perceptible, frequently intermitting and moderately slow pulse.
In a girl, aged 4 years, a large quantity of unripe seeds, produced unsteadiness of gait, small, white blisters on the lips, and
flushed face; at the end of three hours the face was very red,
the eyes injected, the pupils extremely dilated and insensible to
light, the tongue coated, pulse small and moderately frequent;
heart beating violently and irregularly; there was entire loss
of consciousness; frequent groaning; grasping about, with outstretched fingers, as if something had to be seized suddenly;
frightful gritting of the teeth; frequent jerking of the hands
and feet; constant incomprehensible babbling; skin almost natural; abdomen soft.
In a boy, aged 3 years, the seeds caused him to fall down
senseless upon the floor; he thrashed around him; frothed at
the mouth; his face was much reddened; and he had alternate
convulsive movements of the face and limbs.
In a girl, aged 6, the seeds caused paleness of the face with-:out heat of the head; great dilatation of the pupils; smallness
and quickness of the pulse; throbbing of the heart; coldness of




124                    HYOSCIAMUS.
the hands and feet; slight convulsions of the: limbs; squinting;
gritting of the teeth; and unconsciousness.
In a girl, aged 6, the seeds caused: heat of the head and
whole body; redness and bloating of the face; fulness, without
quickness of the pulse; violent and irregular action of the heart;
protrusion with great redness of the eyes and much dilatation
of the pupils; the most happy delirium, so that she sang and
spoke and babbled constantly, but very hastily and indistinctly;
but she became very violent, and struck around her whenever
she was spoken to loudly or taken hold of.
In an adult, three ounces of the seeds, made the face bluish;
the eyes red, wild and sparkling; the veins of the neck and
limbs, but especially of the face, much distended; the whole
body was convulsed; frequently returning subsultus; and such
a furious delirium that no one could hold him. During the intermissions the patient was occupied in trying to catch flies
which seemed to be flying about, or in picking shreds out of his
quilt.  Afterwards he seemed much exhausted and breathed
like one in an apoplexy, from which he was aroused by still
more violent convulsions; the pulse was small, quick, contracted
and distinctly intermitting; tongue dry and clean; hypogastric
region much distended and very painful; urine very scanty;
there was such excessive itching that he expended his little
strength in scratching himself until the blood came; invincible
horror for: all liquids; afterwards perspiration sat in very profusely and lasted for two whole days, over the whole body, but
especially on -the legs, and a pimply eruption broke out upon
the thighs, both before and behind, from the hips down to the
knees; the pimples were large, red and confluent, like those
of small-pox, but did not contain any fluid. His sight remained
very dim for some time.-FRANE.
A  coachman, from  the herb, experienced confusion of the
head, and such stiffness of the arms and legs that he could
scarcely stand, and finally fell down;:his eyes seemed inflamed
for a long time afterwards. —FRANK.
SCHNELLER. froi -four grain doses of Extract, experienced:
mist before the eyes and weakness of sight; dryness of mouth;




HYOSCIAMUS.                      125
yellow coated tongue; great distension of abdomen, with inclination to breathe.deep; sour eructations; scanty stools; rather
slow pulse; also left frontal headache, with ambliopia, frequent
inclination to yawn and sleepiness, with evening nausea. Some
of the doses were not followed by head-symptoms, but merely by
frequent inclination to sneeze, with the feeling as if a catarrh of
the head would set in; also frequent sour eructations, some
little constipation, and good sleep.
In other experiments he had: tickling and burning in the
throat, with increased secretion of mucus, dryness of the mouth,
white tongue, hoarseness, loss of appetite, and some colic; also
peculiar drawing and rending pains in the joints, especially in
the wrists and knees.
Five grain doses caused: thick coating of the tongue, insipid
taste, offensive breath, eruption of small boils upon the face,
dimness of vision and redness of the eyes.  Eleven grain doses
caused: vertigo, gauze before the eyes, headache on the right
side of the forehead, prickling feeling in the arms, followed by
sticky perspiration, with heat, redness and turgor of the face.
At other times he experienced: dryness of the nostrils, pain at
the root of the nose, and excretion of a very little mucus mixed
with blood, &C.-FRANK.
In an adult soldier, the young shoots caused some burning, in
the throat, stupefaction, and a dropsical swelling of the arms
and hands.
Two other soldiers experienced: very violent dizziness, and
they finally fell down as if deeply intoxicated; their eyes were
wild, pupils much dilated, expression fixed and stupid, respiration difficult, pulse small and intermitting; loss of voice, lock-jaw,
risus sardonicus, loss of sensation, typhomania, coldness of the
limbs, paralysis of the legs, carphologia and convulsions of the
arms. The patient who vomited least, had mania with delirium,
but without fury, although it was difficult to hold him, when he
sought to escape.
A girl, aged 4- years, ate one root, and seemed as if intoxicated; she was awake, but without consciousness, did not answer
questions, but looked around the room as if seeking something,




126                   HYOSCIAMUS.
made frequent, but not convulsive motions with the hands and
feet; if she attempted to take hold of anything she grasped to
one side of it; her eyes were wide open, pupils dilated, pulse
natural, and face reddened.-FRANK.
Four children, from 4 to 8 years of age, ate of the leaves:
They began to stagger, then fell down in convulsions; their
faces were bloated, skin dry, pupils excessively dilated, eyes
turned upwards and inwards. In one child the abdomen was so
much distended that it seemed as if it would burst, but without
pain; the tongue was stretched far out of its mouth, turned up,
and occasionally thrown spasmodically against the nose. In the
two youngest, such violent convulsive movements sat in at times
that a strong man could scarcely prevent them from injuring
themselves; when free from convulsions they spoke much, very
hastily, and unconnectedly. The two oldest were affected quite
differently; they lay quite quietly in a perfectly stupid and
unconscious state. None of them  seemed to be in pain; all
seemed comfortable, and one was occasionally merry and silly.FRANK.
Two girls, aged 5 years, ate several capsules, and were attacked with trembling of the limbs, anxiety, restlessness and
confusion of words and actions; in six or eight hours they were
talking incessantly and confusedly, they laughed and sang at
times, did not know their relatives, had frequent spasms of the
facial muscles, especially if one attempted to hold them or take
anything out of their hands, when they became violent and attempted to bite, pinch and scratch; they seemed very strong in
their hands and feet, and at times attempted to dance; they
gritted their teeth, and had a spasmodic stretching out of their
tongues, with a peculiar trembling motion of it; their eyes were
brilliant and rolled about unsteadily, and were reddened; the
pupils exceedingly dilated and insensible to light; pulse almost
extinct, small, and very quick.-FRANIK.
CASE 62.-A man, aged 24 years, healthy and strong, got
sick after a severe chill. On the second day the malady was
the following:
rSymptoms. —He lay senseless with closed eyes, did not open
them when spoken to; his mouth could be opened with diffi



IOD NE AND HYDRIODATE OF POTASH.            12T
culty; tongue, covered with a white, foamy slime; he dreamed
about business affairs, animating his servant to work; he sang
unintelligible songs; murmured, laughed and then became quiet
again, started often, worked with his hands, as if he intended to
prick on the ceiling; pupils enlarged, eyes dull, face red, skin
dry and parched, breathing quick and anxious; pulse regular,
but full, abdomen somewhat contracted, but he did not complain
of pain if touched and pressed.
Prescription.-Hyosc. 6., one drop per dose, in half an hour
after, slept for four hours, passed urine involuntarily; seven
hours after, awaked with consciousness. On the following day,
some signs of inflammation of the lungs were soon removed by
Arnica. -MoSBAUER.
CASE 63.-It- was useful in an affection of the brain, attended with convulsions of the whole left side of the face and
body; the right arm and the right leg constantly affected, although not spasmodically, while the limbs of the left side, without being paralysed, lay quite still. Ipecac. was of no use,
but Hyosc. effected a speedy cure, and caused a quiet sleep.GROSS, Jr.
REvIEW.-The presence of redness of the face, delirium,
picking at the bed-clothes, fright, convulsions, are indications
for the use of this remedy.
IODINE  AND  HYDRIODATE  OF POTASH.
Iodine acts principally upon the absorbent system, and the
particles absorbed are quickly ejected through the kidneys, as
the urine is generally much increased in quantity; some persons experience this latter effect so instantaneously that Iodine
has been detected in the urine almost immediately after each
dose has been taken. This excessive absorption and drain from
the system may lead to great emaciation, or it may excite an increased demand for food so that one of the first and most important effects of this remedy may be a great increase of appetite,
which will enable us with ease to invigorate the constitution by
wholesome and sufficient nourishment. Again, although it is
well-known to all practical men that Iodine acts as a diuretic, it




128       IODINE AND HYDRIODATE OF POTASH.
is not equally known that the Iodine-urine contains large quantities of urea. Now, urea is the product of the decomposition of
the albuminous tissues, and as it has been clearly shown by
chemical analysis that tubercle is composed chiefly of albumen
and caseine, we can understand how Iodine acts by carrying a
large quantity of albumen out of the system, thus retarding the
growth and promoting the absorption of tuberculous matter.GLOVER. We have already seen that Hepar.-sulphur diminishes the quantity of albumen in the blood; it might be advisable to put a tuberculous subject upon alternate courses of
Hepar.-sulph. and Iodine,; the one to diminish the quantity,
and the other to expel the excess of albumen from the system.
WARING says: In tubercular meningitis or acute hydrocephalus Iodine has been used with benefit. Drs. CHRISTIE
and WONINGER relate two cases which had reached the paralytic stage, but which recovered under the external and internal
use of Iodine. Dr. BENNETT has derived decided benefit from
Iodine and its preparations in this disease; and Dr. WILLSHIRE
bears similar testimony; he advises the use of Iodine externally and internally in the early stages of the disease, before there
is much evidence of congestion and inflammation; he applies
the Iodine-ointment to the shaven scalp, and gives internally,
gr.' of Iodine and gr. iij. of Potass.-iod. in solution, every
three hours; this, aided by turpentine enemas will be found in
most cases a palliative, and in some a curative mode of treatment. Dr. RILLIET advises the use of Iodine frictions to the
shaven scalp in the second and third stages of hydrocephalus.
ROWLAND HOSKINS relates a very aggravated and apparently hopeless case which yielded to the Iodide of Potassium in
half-grain doses, every four hours; but Scammony was given at
the same time as a purgative. Another case illustrative of the
efficacy of this salt, is related by Dr. GUEROUD. Dr. COPELAND also states that he has prescribed it in small doses with
evident advantage.
CASE 64.-A child, aged 22 years, was attacked with fever
and vomiting, followed on the third -day by convulsions, and all
the signs of dropsy of the brain; on.the fourth-day the eyes
were open, squinting and dim; the pupils much dilated; there




IODINE AND HYDRIODATE OF POTASH.              129
was unconsciousness with incessant screeching, without weeping; entire blindness; the eyes were moist, the edge of the
lower lid relaxed and inverted, (entropium); the little patient
lay on its back, with its head pressed back into the pillow;
when it was raised up its head fell back hopelessly; there was
entire paralysis of the right limbs, with partial palsy of the
left; frequent, involuntary and automatic motions were made
with the left arm and leg; drinks passed over the clean and dry
tongue into the windpipe and excited spasmodic coughing; the
urine was scanty; the cheeks which had been pale yesterday
were red to-day; the pulse wvhich had been slow and irregular
yesterday was very quiclk to-day; the whole body was in a dripping perspiration, notwithstanding that ice was applied to the
head. The last febrile reaction had taken place previous to
dissolution.
Treatment. —-Kali-hydr. 1 drachm in 2 oz. of water, 30 drops
per dose, every hour; notwithstanding the difficulty of swallowing,
the whole of the above medicine was given in ]less than twentyfour hours and the prescription repeated, without alteration of
the symptorns except an increase of the dryness of the mouth
and thirst; but on the tenth day of the disease, and the
second day of this treatment, the first traces of improvement
were observed in commencing contraction of the pupils; on the
seventh day consciousness was restored, there was regular movement of the pupils, natural position of the eyes, the countenance
was expressive, the little patient belan to move the left hand
and arm, and two days afterwards motion was also restored to
the right side; great appetite set in, and many small boils broke
out on the face and neck. Finally this critical eruption of boils
became a perfect torture to the child, for at least one hundred
large and small ones appeared first and last upon the head, back,
neck, -ace and chest; shortly after the pimples appeared, they
quickly changed without much redness or inflammation into
larger or smaller abscesses, some of which attained the size of a
hickory-nut and then burst.
At the end of four weeks the child Twas perfectly well of disease and eruptioon, after using about ten drachms of Iodide of Potash in the course of eleven days. —Frank's Magazine, Dr. ROESE1.
CASE  65. —A  case of hydrocephalus progressed notwith



130        IODINE AND HYDRIODATE OF POTASH.
standing the most active antiphlogistic and derivative treartment
into the second stage. but after the use of half an oz. Iodide of
Potash in the course of three days, consciousness had returned,
the pulse was no longer irregular and intermitting, but still frequent; a perfect cure was effected in six days by smaller quantities-about two drachms more. Tartar-emetic ointment had
also been applied to the nape of the neck. —Dr. VEIT.
CASE 66. —A girl, aged 6 years, after eight days of sickness, lay in a deep stupor, from which she occasionally started
up with screaming; the pupils were dilated, one considerably
more than the other; the eyes were insensible to light, with
squinting; she could be rendered conscious for a short time by
shaking and loud talking; she gritted her teeth in her sleep;
the pulse was quick and irregular; she could still move her
limbs, hold up her head, and swallow.
Treatnient. —IKali-hydriod. was used without aid from any
other medicine; at the end of two days and afteir taking
drachms ij., all dangerous symptoms had disappeared, theposition of the eyes was natural, the pupils normal, and stools
regular.  But great redness of the cheeks and strong pulsation
of the carotids set in, calling for the omission of Kali-hydriod.
and the use of Calomel, leeches and cold applications to the
head: on the next day this congestive and febrile paroxysm had
subsided, and the face was again pale, but the stupor sat in
again, and the pupils became dilated and sluggish.  Kali-hydriod. was resumed, and in five days more perfect recovery had
taken place.-Dr. VEIT.
CASE 67.-A boy, aged 31 years, of strong constitution and
active temperament, but who had frequently suffered with crustaserpiginosa and catarrho-scrofulous opthalmia, was attacked with
incipient inflammation of the brain, and treated with Calomel,
&c., from the 17th to the 26th of June, when all the signs of
effusion sat in; he was entirely unconscious; tossed about the
right leg in a restless manner, while the' left lay paralysed
and motionless; occasionally sudden starts of the whole body,
and screaming fits; the eyeballs were drawn spasmodically upwards, and only partially covered by the lids; the pupils were
entirely immovable and very widely dilated; the conjunctiva
was reddened and the cornea and edges of the lids covered with




IODINE AND HYDRIODATE OF POTASH.              131
purulent mucus; the nostrils were dry; face pale and sunken;
mouth distorted and partly opened, with frequent sucking motion of the lips; tongue moist; gums touched, and together
with the teeth and lipts were covered with brown sordes; there
was frequent gritting of the teeth; slow and unflrequent pulse;
dry skin; great thirst; constipation and talmost entire suppression of urine.
Tr eatmenzt'.- Kali-hydriod., half a drachmn in three ounces of
water, and one ounce of simple syrup, a moderate tablespoonful
every two hours.  On the next day, with the exception of some
congestion of the head, for which seven leeches were applied to
the mastoid processes, there was evid(ent improvement, which
progressed steadily under a renewal of the prescription on the
28th and 30th of June, and 2d of July.  The critical appearances were a profuse secretion of urine, which was at first turbid, but soon became clear; severa.l semi-fluid stools;.moderate
warm perspiration, some white miliary eruption upon the chest
and neck, especially in the outbreak of boils upon the forehead,
scalp and nape of neck; these were of various sizes, some as
large as a hazel-nut; they suppurated andt ulcerated, and their
irruption was aided by the application of Tartar-emetic ointment
for several lays.  Dryness of the mouth, and a frequent, dry
cough, were also noticed as effects of the remedy.  The child
was entirely restored in eighteen days, under the use of half an
ounce of Ilydriodafe of. Potash.-AMELUNG.
CASE  68. —A  little boy, aged 2~ years, suffering with
dropsy of the brain and consumption, was so far restored by the
use of six drachmrs of Kali-hydriod. in four days, that there
seemed but little doubt that lie would recover from the brain.
disease.  The pupils becamne regular, consciousness was restored, although the little patient could not speak, he could hold
up his head somewhat, and move his emaciated limbs, he passed
much urine, had several stools per day, and pimples and boils
commenced to break out upon his head, aided by the application of Tartar-emetic ointment.  Finally the hydrocephalic
symptoms disappeared entirely, but the child ultimately died of
consumption. —Dr. ROESER.
CASE 69. —A boy, aged 2- years, previously quite healthy,




132       IODINE AND HYDRIODATE OF POTASH.
was attacked with decided inflammation of, the brain attended
with fever, headache, contracted pupils, intolerance of light,
vomiting and constipation.
7Treatment and Result.-Eight leeches were applied to the
temples, and two grains of Calomel given every two hours; the
3Mercury had not operated upon the bowels at the end of several
days, the vomiting had ceased, the headache persisted, also the
stupor  -from  which, however, the little patient occasionally
started up with fightful screams.  Ice was applied to the head,
six more leeches to the temples and a blister to the back of the
neck.  After the use of several drachms of Calomel, the constipation persisted and the most decided signs of dropsy of the
brain sat in.  There was constant stupor, squinting, very much
dilated and insensible pupils, frequent automatic screaming,
dirty and dry tongue and slowness of the pulse.
Treatmenet. —Kali-hydriod., two drachms in one and a half
ounces of water, twenty to thirty drops per dose, every hour;
the whole quantity to be used every twenty-four hours.  At the
end of two days several loose stools had occurred, the pulse was
fuller, harder and quicker, the pupils somenhat contracted and
sensitive to light, gums touched by Mercury.  At the end of
nine days consciousness was entirely restored, pupils natural,
sopor gone, and there was only a little squinting with one eye.
Violent mercurial gangrene of the mouth was followed by
great restlessness and delirium; and the Hydriodate of Potaash
was stopped, but had to be resumaed again in seven days on account of a, return of the brain symptoms; two drachms were
used per day with rapid improvement for seventeen days, when
the. patient had perfect possession of his mental faculties, was
stout and blooming, but some of his teeth had fallen out, and
part of his jaw-bone was loose. —Dr. ROESER.
N. B.- Since ROESER has resorted to such heroic doses of
Itydriodate of Potash, sometimes using three ounces and six
drachms in one case, he has only met with three fatal cases out
of nmany; in one of these cases a post mortem examination reyealed tubercles and ulceration of the lungs; in the two other
cases the remedy was given too late and quite irregularly.
CASE  70. —A boy, aged 5 years, was attacked with violent in-flammation of the brain, eight days after a fall upon the
head.




IODINE AND HIYDRIODATE OF POTASoH              133
JSymptoyns.-Perfect stupefaction and blindness, heat of the
head, iminoveableness of the pupils, entire suppression of all the
secretions, quickened pulse, and violent, finally incessant convulsions, passing over into opisthotonos.
Treatnent. —-After the fruitless use of leeches. ice to the
head, Cfalomel and Sublimate in unction, IKali-hydriod. was
given, one to two drachms in two ounces of water,  a teaspoonful per dose.  At first the symptoms were rather aggravated, but improvement soon sat in after the occurrence of profuse urination and copious discharge from the nose. —ZIMaERMANN.
CASE 71. —A boy, aged 2 years, previously afflicted with
eruptions upon the head and face. was attacked with violent inflammaticn of the brain, apparently in consequence of repeated
falls upon the head.  Very active antiphlogistic and counterirritant treatment had produced no good effect at the end of five
days, on the contrary all the signs of effusion had taken place.
Symptons. —The eyes were fixed and watery; pupils immoveable and widely dilated; absolute blindness; tetanic rigidity of the muscles of the nape; retraction of the head; paralysis
of the left side; deep stupor; slow pulse, down to 50;  frequent
sereamrnimii and vomiting.
Treatment. -Kali-hydrio., one drachm  in half an oz. of
water, forty and finally fifty drops per dose, every two hours;
without improvement for the first three days; but on the fourth
day of the Potash treatment and ninth of the disease, profuse
secretion of urine sat in, with evident improvement in all the
alarming symptoms; after the use of two drachms of the FRydriodate he was almost out of (langer on the twelfth day of the
att ack.-Frank's Magazine.-Dr. WOENIGER.
CASE 72o-The head of the patient at birth was unusually
large and the fontanelles widely separated, the mermbralnous
portions being quite protuberant, with fluctuation; the child
had had frequent convulsions and occasional paralysis.  When
Dr. BARBOUR saw the case, the head was of monstrous size;
the fontanelles very large, the anterior being at least three
inches in diameter, and occupied by a large fluctuating tumor,
elevated about an inch above the level of the skull; the sagittal




134         IODINE AND HYDRIODATE OF POTASH.
suture  vas widely open, and all the bones of the head quite
moveable and compressible; his neck was remarkably emaciated
andl slender, so much so, that the weighty head could only be
sustaine(l by the shoulder on which it constantly leaned.  Chronic diarIrhore also existed, attended wi th general emaciation, tumid
abdomen andl irritative fever; in fact he. presented the most
prominent symptoms of marasmus in connection with chronic
dropsy of thle brain.
Tleatmllt.-In order to improve the secretions and check
the (lirrl1oea. IIiyrarg.-cicuta anl Pulr.-dover, grs. xv., made
into twelve powders, one every six hours; this had such decided
effect that an occasional laxative hIad to be given.  To promote
the absorption of the fnuid and improve the general constitution:
Hydriod.-potass., half a drachm in 2 ounces water, one teaspoonful. three times a dav was given.  A  blister was applied to the
head, and frequent (fifusions of cold water were used.  This
course was continued for six weeks, an(i the result was highly
gratifying; the irritative fever gra(dually yielded; the head
diminished in size, day by day; the fontanelles became gradually reduced to their natural  size; the convulsions did not
recur; and the little boy gained flesl,, strength and color, and
finally appeared perfectly iwell.  Di'. B AnRouR's great reliance,
at least theoretically, was upon the Hydriodate of Potash.
CASE 73.-A giil, 12 years of age, was attacked with arthrit. acut. va,ga.  About midnight on tlle 16th of Janufary, she
became delirious and restless, somnetinmes sitting up in bed, at
others.lying down again.  Tlhe infla.mmantion of the wrists had
ceased, (andl appeared to settle in the meninges;  the patient was
nea.rlyv given up.
Treatment —Iotd.-solout.,    (ten gran. in half ounce of Alcohol,)
two drops, p. d(., to be taken half-hourly, for one day; on the
second dltay, hourly; on the two following days every two hours.
On the 17th the consciousness was already regained, the right
hand 111ad re-inflanled, the mehirlges iwere free.  She then took
Ant.-cr. an(l  Bryon., and on tie 26th was also recovered from
the arthritis.- ScnrMID, 130.




IODINE AND HYDItIODATE OF POTASIT.               135
NATURAL CURES.
CASE 74. —A boy, aged 21, years, robust, with a large head,
and prominent forehead, was taken sick on the eighth of Deceniber.  Six days afterwarlds acute hydrocephalus, was fully d(eveloped; the Tfontanelles were still widely open; leeches, Calomel, &c. were given without benefit, and on the eighteenth day
the boy lay helpless and stupefied; his head and faice were
alterna.-tely hot and red; he gritted his teeth; the pupils were
dilated and insensible to light; he swallowed: fluids hastily:
this state lasted two (lays more, wihen  larger quantity of clear
watery fluid flowed from the ear, and the patient improved on
the sanme evening; profuse flow of urine also sat in and lasted
for several days; in a few days more the little patient was
decidedly convalescent, and recovered perfectly in six weeks.
Two profusely suppurating spots also formeld on the back of the
head(.  The author had previously witnessed a sinilar case. —
RIEC E.
CASE 75. —A little girl, aged 4 years, had been sick for five
days with inflammation of the brajin, for which slhe had received
no medical treatment, and now seemed at tllhe point of d(eath.
HIer face was red; eyes rigid and immoveable; bIrethin'frequent and irregular; pulse lihard and intermitting; for two
days everything that she had swallowed had been ejected argain
through the nostrils.  Ice to the head,  leechies and injections
were used without benefit; at the end of eight days more, hler
face was pale and sunken; nose and ears col(l; pupils dilated;
eyes turned up; mouth open; breathing scarcely perceptible;
pulse small, frequent and intermitting;  constipation for eight
days, and no urine had been passed for three (lays; the right
arm  and leg were moved automatically; tlle whole left side
seemed paralyzed.  On the next tlay the whole scalp was slightly reddened and covered with an immense nlmber of small
miliary vesicles, which increasedl in size for two dlays more, then
ran together, burst and discharged a large quantity of yellowish
watery fluid, followed by improvement of the brain symptoms.
At the end of a few days more the whole head and face were
covered with a thick scab, throurgh the fissures of which a bloody




136        IODINE AND HYDRIODATE'OF POTASH.
serous fluid exuded; evacuations from tlhe bowels and bladder
had commenced.  In eighlt days more the little patient was cut
of danger; but she did not recover lher specch or the use of, the
left side until after the lapse of many weeks. —MiALIN.
CASE  76.-A  little boy, aged 1- ycars, became sick two
weeks after an attack of scarlet fever; gradually all the signs of
dropsy of the brain developed themselves; his face became
pale; pupils dilated and fixed; the corjurwctiva reddened; cornea dull and coated iwith mucus; entire stupolr for three days;
convulsions of the right side; boring of the hlead into the
pillow; vomiting and constipation hadl  beenn followed by involuntary diarrhoea;. pulse was smnall and frequent, w-ith occasional intermissions.  Elder tea caused suchl a rIro1use p1erspiration that a large bed was saturated both above and below, and
the child speedily recovered.-RITSCI-i ER1.
CASE 77.-A boy, aged 1~ years, lhad so large and hleavy a
hydrocephalic head that he could not bold it up vithlcut sulpport;
the head was soft and dcugly to the feel; the fontanelles were
wide open; the rest of the body delicate and relaxed.  At the
end of five years the reporter -was surplrised to find hin  alive
and well; the head was only a little lar'ger tlan natural; the
bones were firm and closed; the body well nourlished; the mental faculties moderately developed; the parents assured him
that no medicine had been given and tllhat everythling had been
left to nature.-Frank's Magazinee. —   onFA iiLLER.
CASE 78. —An infant, aged 6 montls, had suffered severely
during the month from cold, whliich resulted in an enlargemen~t
of the head, which was one-third larger than natural; the sutures were all widely open, the fissure commencing at the root
of the nose and extending up the forehead, being one inch
across; the anterior fontanelle was capacious enough to admit
three fingers; the coronal and sagittal sutures were also widely
extended; the scalp covering thlese broad fissures was puffed
and elastic to the touch, indicating the presence of fluid beneath.
Dilatation of the pupils, squinting, jerking of the limbs, screaming, tossing of the arnas upwards, plainly denoted the dropsical
nature of the little patient's brain affection; the bowels were
also costive, and vomiting fiequently occurred.




IODINE AND HYDRIODATE OF POTASH~              137
Treatmnent.-Kali-hydriod., twenty-five grains, gradually increased to forty grains to the ounce of lard, to be rubbed over
the whole head, twice in twenty-four hours; also a solution of 20
grains to the ounce of water, ten drops to be given morning and
evening.  This treatment was continued for nearly one month
without benefit; then blisters iwere ordered to the head; first
on one entire half, and then on the other, so that one side was
always under the influene of the irritant; two grains of blue
pill were given twice daily; but in spite of this, general anasarca sat in, and I-ydriodate of Potash ointment was applied
over the whole chest and abdomen.  And now appeared the
crisis of the case, for a vesicular eruption broke out over the
whole body, the vesicles bursting and discharging pure lymph.
From  this critical discharge, the convalescence of'the patient
commenced, but the remedies were still continued for four
months, when the child was perfectly healthy and sprightly,
although there was still some obliquity of vision.
Dr. KENNEDY asks: Is the treatment of the more ordinary
or sub-acute form of hydrocephalus too heroic? I e believes it
to be so, in the allopathic school, and that a better prospect of
cure will be held out by a treatment a good deal modified from
that in common use.  Of bleeding he is fully satisfied that very
little of it will answer every purpose; he has even noticed that
cases left to themselves, without treatment for days, did not
appear to run a more rapid course than those where active
measures had been adopted from  the outset.  To Aerctury
similar remarks, Dr. KENNEDY thinks, apply.  It would seem,
as far as he has seen, to be used as a sine qua non; and yet
the results do not appear to justify such faith in it; he has
notes of more than twenty cases of hydrocephalus, in which the
specific effects of lercury were produced, and yet in not one of
these cases was the result favorable, to say nothing of others,
-vhere salivation could not be induced.  Is it right to give
Mercury to weak and strumous children, he would ask, and do
our utmiost to induce its specific effects  The answer to this
must be in the negative.  KENNEDY gives four cases, which
include all those of recovery which he has seen in a period of
several years, after the disease had passed into the second
stage, that is when the pulse had fallen.  Now it is specially




138         IODINE AND) HYDRIODATE OF POTASH.
worthy of notice that three out of four had never been salivated,
and in the fourth salivation was produced more by accident than
desii yn,
Treatment.-All four cases were leeched; the grey powder
in very mllinute doses, as:n altelrative was administered in antimoenial powder; blistering 7wa(s very freely used, at first in the
ordliniry mnode, and subsequently in two cases, under the form
of the Tartar-eimetic plaster applied to the head; and in this
way a constant dischar<ge was kept up.  But, in addition to
these m-easures, particular attention was paid to keep up the
strenrthl; some got beef-tean.and others wine, and this while the
disease wals still present.  A child of six years of age, got two
ounces of wi'ne, which was increased to three in the day, and
this while the pupils were still dilated, while the screaming
was conlstant anti the convulsions persisted; and it was apparently uniler its use tlhat this child rallied.
Several of the natural cures took place after the outbreak of
pustules iupon the head, or eruptions over the body.  Dr. HAHN
has saxved fourteen cases by means of frictions of the scalp with
Tartar-emetic ointment, repeated. every two hours, until pustulation is established; he elarims to have saved fourteen cases in
apparently a hopeless state of coma.
CASE  79.-A  fine boy, aged 9 months, was suddenly attacked with convulsions; he recovered from these and cut his
first teethl shortly (afterwardls; but soon begpan to fall away, to
become listless and lose his -appetite; his bowels became constipatte(l; pulse irregular; he also began to vomit and to become
torpi,,l; fever was *oon added to his symptoms, and it was evident that he was the subject of menincgitis.
T'reatmnenzt.-Leechles were appliedl; and Calomel given, but
in spite of this treatment he lapsed into complete coma..  As
soon -as the coma became distinct, Tartar-emetic ointment was
rubbed into the scalp every -four hours, over a space the size of
a crown piece; free suppuration ensued and signs of improvemnent were  speedily witnessed;  the child  grdually  became
more conscious, his appetite returned, and in two weeks all
traces of his disease had vanished.




OPIUMio                        139
0 PI U M.
GIENERAL REMARmIs.-According to WARIrNG Opium is generally contra-indicated in acute inflammation of the brain, wvihich
tends to'produce death by coima; there are, however, oCc;asioial
exceptions to this rule; as, for instance, in innflammation of the
brain, in which Dr. GjIUFFIN states that Opium, given in cornbination with Tartar-enetic, exerts an extraordinary power in
allaying nervous irritation, quieting  increased  action in the
capillaries, and inducing sound and refreshing sleep. It shoull,
however, be employed with extreme caution, and only by one
whose experience in this class of diseases gives him a title to
depart fron what is generally regarded as safe practice.
In delirium  occasioned by inflammatory action of' the brain,
or its nmemnbranes, particularly when it assuaies a mniniacal or
violent character, and after depletions have been carried as far
as may be thought pruident, and the bowels have been fieely
evacuated, Dr. COPELAND states that lie has firequently seen a
full dose of Opium or Hyosciamus, given either alone, or wvith
Antimony and Camiphor, produce the ha1ppiest effect.  Any unpleasant symptoms which  may result, either friom too large
doses of these narcotics, or from  their inappropriate use, will
readily be removed by the cold or tepid affusion upon the head.In hcldrocephalus, Opium  has sometimes been eimployed in
the second and third stages, to lessen the acute pain in the hlead,
convulsions and irritability of tlhe stomrnach and bowels; and
may be given with this view, at ant early period when dropsy of
the brain dtepends upon exhaustion and debility uncon'plic.ated
with inflammation.  It has often succeeled, observes'Dr. BEI:NNETT, in effecting this without in any way interfeting  with the
action of other remedies, or in'ducing constipation wien moderately employed.  At the early period of the secondl stage, it
may be given with Calomel, Jai-mes' powder, or Tartar. ernetic,
in doses varying from gr. - to gr. 4, every four hours.  According to CRAMuiPTON and CHIEYNEl,  contraction of the pupils following  the exhibition of this renmedy indicates that it lhas been
pushed sufficiently far. Dr. PRISoN BENNETT hlas since stated,
that, avoiding its use when the pupil is contracted, lie has em



140                          OPviM.
ploycd Opium,with the best eiect, and has sometimes saved an
apparently hopeless case.  Drop doses may be repeated every
four l'ours, if no unpleasant symptoms present themselves. —
~-WA RING.
WJr,:sr  says:  In the treatment of many diseases you see
physiciuanls destroy pain by narcotics, and the question naturally
suggests itself to you whether  you may not sometimes venture
inl thle imannagrencnt of hydrocepllhalus to initigate by their means
your patici ts-suf-  Feriin's?  The inquiry is one not very easy to
reply to sltisfiectorily.  I thlink, however, that there are two
conditions undler whiich you will be justified in trying the experiinent of giving theim.  Sometimes the disease sets in with
great, excitement, and a condition closely resembling mania in
the adult, syImptoZms whicll may hiave been ushered in by convulsions.  In suci  a case althllouh the lieat of the head and
flushI of the fiace may lave disappeare( after free depletion and
purgation,-; ai(nd though the pulse is feeble as well as frequent,
yet the excitement many be searcelyif  at all diminislled.  Here
an opitate will somnetimes (give relief which nothing else would
procure; your patient will fill asleep and wake tranquilized in
the course of two or thlree liours.  In otlher cases which (lo not
set in t:hus violently, restlessness, talkativeness, or a kind of
half-delirious consciousness of pain in the henad, become very
distr'essing as thle disease aldvances, being alwaJys aggravated at
nighlt, so  lhat your patient:s condition seems one of constant
sufferingl.  Udl(ler these circumstances, I [WEST]- have sometimes given a, full (lose of Morphia, and bhave continuedl it every
nirght fir several nights together with  manifest relief. —PETElRS.
CASE 80. —Gtoss observed during the winter months, in a
numberc of chil(ren, undler" 7 years of age, a rheumatic-inflammatory affection of the Inelinges, whllich lie treated according to
circumnstances vwith iBellad., &c.  In some, tle following condition plevxail1dl: They were continually in slumber, with snorinl  annd hIi lfopened eyes, vwere awakened with difficulty, on
awakinl, illsensible, coniplaining of nothing, wanted nothing, but
vomitetl fiequently.
Tj'eatnieit.  -Opiuni 6., cured generally within a few hours.
-Arch. 9, 2, 140.




OPIUM,                         141
CASE  81.-A boy, aged 4 years, after a fai1 upon the head,
got an attack of lhydroceph. ac.-Acon. was taken first, then
Bell. 30., and( after fourteen hours le appeared to be out of
danger.  The recovery progressed until thle fifth c(i;y of the
disease; but there still existed a state of apatfhy, accorapanied
by a short, dry cough, constipation,  all of vlich were relieved
after Bryon 30. had been taken.  On the seven th day of the
malady he had the folloiwing:
Sy,]~)Jtomns.-An increased condition of stupefaiction, the Iris
more insensible than in the last few days, the eyes not quite
closed in sleeping.  Three large  wormis passed wvithout excrement through the fundarmeunt.
Trealtnezt.-Opium  6. followed by sixteen hours sleep and
after aw-aking, by a -profuse sweat, when th-e brain was entirely
relieved. -B ETH MANN.
CASE 82. —A  girl, aged 17 years, of delicate phlegmatic
constitution, whose sister had died with hydroceph. acut., complained of dizziness, headache, and vomniting, which increased
daily; for four weeks she had been surly, and had lost lier good
looks; her cheeks were hollow, face  pale yellow;- eyes weak
and without expression; the brain appeared as if oppressed by
a heavy burden.
T reatnzent.-Bell. 18. in solution; she soon became unable
to speak; was continually drowsy; she stared vaguely when
spoken to, without giving any answer; all the former symptoms
remained.  Opium  4. in solution, two spoons-ful mor1ning and
evening, was followed by a tolerable state of quietness, and the
excessive desire for sluep disappoai ed   the patient improved
rapidly.-Moom.
REvlvEW.-In the foregoing cases we find an amazed and
stupid state, continual slumbering  with hblf-opened eyes, snoring, and insensibility of the iris.  aGueoss observed principally
a rheumatic-inflammatory irritation of' the inening;es; in one case
a fall upon the head preceded the attack, and Aecon., Bell. and
Bryon. were given, with little effect; in another Bell. was prescribed without benefit.  The doses, Opiuom 6. in two cases; the
4th dilution, in solution, in one case.  This remedy is so decidedly homoiopathic to congestions of the brain, that't deserves
more frequent trials.




142                 hHUS-TOXICODEN DRONo
RH - U S - T O X IC O D  N D 1N 0 N.
GENERAL REMARKS.-Rhus is peculiarly homocopathic to
inflammatory cedema, and to all inflamnmations attended with a
copious effusion of serum; hence to all inflammatory dropsies,
and to dropsy and cedema of the brain.  In this respect it is
the analogue of Arsenicurn and Cantharides.  If it were possible to obtain and retain the recent juice in all its original
activity, it woiild probably forni a more efimcieint external application than Cantharides, Croton-oil or Tartar-emetic.
It wvill perhaps prove most useful in the paralytic stage of
hydrocephalus, and in those cases which arise from  the suppression or retention of eruptive diseases.  At least DUFItESNOY, army physician and professor of botany in Valenciennes,
employed it with success against tetters and paralysis.  Of the
twelve cases he published in 1788, seven refer to cutaneous affections, and five to paralysis consequent upon convulsions.
PONTAGNON of A/Iontpelier cured a paralytic patient in a fortnight; and GONAN  cured a young lady in a few weeks of
hemiphlegia.  VERDEGEN, KOK and VAN BAERLEMI obtained
similar results.  Finally ALDEtSON of England has published
seventeen cases which go to prove the efficacy of Rhus against
paralysis, and in general against all affections characterized by
debility of the muscles.  HULL andt DUNCAN- also advise it.  It
proved successful in four cases in which it was employed by
DUNCANr; in each, a peculiar feeling of pricking or twitching,
preceded permnanent benefit.  This sensation was so unpleasant
that Dr. PDUNCAN  wts obliged to discontinue it in one case.  In
general it operated as a gentle aperient, notwithstanding  the
torpid st ate of the bowels of such patients.  In bad cases it
may be commenced in doses of gr. j. of the dried leaves, and
continued until grs. iv. or v. are taken daily, or until a pricking
sensation is experienced in the affected part.  Frictions with
oil in which the fiesh leaves have been digested may be employed at the same tine.-PlraTuls.
In the inflammatory dropsy of the brain, Rhus is, particularly
in the second stage, or that of the effusion, one of the most
important remedies.  It is indicated when there is a soporific




RIHUS-TOXICODENDRONo                    143
condition, inclination to paralysis, with a continuance of the
sensorial activity; when there is a sense of fluctuating of the
head, turning dizziness, alnd a painful, anxious -disturbance,
principally on the hind-head, where the patient feels the'fluctuating; when there are convulsive motions of the limbs, with
great complaint of severe  headache; iwhen the patient lies for
a time in a state of dizziness, until the moire severe attacls are
renewed in shorter intervals; this hopeless state may often be
cured within a few hours with this remedy. —H:ARTA.xNN.
CASE  83. —A  little girl, 8 years of age, suffering for ten
days with inflammation of the braini, showed the following:
Synrptorns.-Loss of consciousness for two days; the right
upper and lower limbs paralyzed; pulse quick, trembling, scarcely perceptible; urine passed involuntarily; slow breathing with
frequent sighing; general appearance cadaverous; eyelids cedematous and swollen; body cold.
Tr':et.-ment.- Arsen., Digit. and Merc.-s. produced but transient improvement. —Rhus. 6. one drop in one ounce of water,
every four hours a teaspoonful, led within twelve days to a
complete recovery.  The second day after commencing the
Rhus., a moist cough appeared, which is to be considered as a
favorable sign. —STvRM.
STURaM remarks, that in eight cases of Hydroceph. ac. which
he had treated, (the above one is the third,) were under the unfavorable circumstances of the already existing second stage, a
recovery was obtained.  In the first case Digit. and  -Iyosc.in the second Mere., Arnica and Sulph. were the efficient remedies; the other five cases came under treaatment at the beginning of the disease.
REvIEw. —But little, yet enough is to be remarked, in regard
to the use of REhus., in the second stage of inflammation of the
brain.  HARTMAANN Says it removes an inclination to paralysis,
and STURM that it cured paralysis of the upper and lower
limbs.   The cadaverous kappearance, cedematous and swollen
eyelids, are symptoms we often meet with in cases cured with
RPhus.




144                    STRAMONIUMtt
S T R A M O N I U M.
GEN-ERAL REMARKS. —The action of this remedy is very
similar to that of Belladonna, (see page 88); it seemns to act
principally upon the blood and many of the ramifications of the
great sympathetic nerve, especially in the brain, eyes, throat
and genital organs.  Its action upon the throat and skill is
similar to that produced by the poison of scarlet fever; it is
apt, like Belladonna, to produce paralysis of all the involuntary
muscles, or those supplied by the sympathetic nerve, while its
action upon the motor or spinal system of nerves, is nearly the
opposite of this, or that of an irritant: thus it produces dilatation of the pupils, spasmodic contraction of the muscles of the
face, relaxation of the cardiac and pyloric orifices of the stomach
and of the muscular coat of the stomach and bowels, while
it causes violent spasmodic contraction of the muscles of the
throat; it will allay spasms of the bronchi, and excite cramps
of the muscles of the limbs, &c., &c. It does not act upon the
glands like Belladonna.
A tablespoonful of the seeds produced in a man aged 60, and
his wife: vertigo, stupefaction, coma and spasms; their respiration was stertorous, they were completely unconscious, with
hanging down of the lower jaw; they had cramps in the hands
an(d feet, and rolling of the eyes with dilated pupils and intolerance of light; they made automatic motions and graspings with
the hands, sometimes towards the nose, ears or head; the skin
was cool, pulse somewhat quickened, with occasional intermissions; the swallowing of fluids was very difficult.  After vomiting and purging there was some return of consciousness, with
abatement of the cramrps, but the face and hands remained cold;
they had some burning pain in the distended abdomen, and
their voices were hoarse and lisping; swallowing was painful
and di'fficult. —-F IANK.
A girl, aged 4, ate of the seeds; she complained of pain in
the ears and was put to bed; but instead of sleeping she became more and more excited and began to sing and speak confused stuff; her eyes were bright, pupils dilated and almost
entirely insensible to light; pulse tranquil and skin cool; she




STRAMONIUM.                     145
began to talk almost incessantly in a most confused and incomprehensible manner, and often wept; she grasped frequently
with her hands into the empty air, as if she would seize something,-and occasionally seemed to be seeking something in the
bed with her fingers; she could not stand for her knees bent
under her immediately when she attempted it, and when she
tried to rise she fell staggering about as if intoxicated; the
abdomen was soft and painless and she was not thirsty. She
recovered after free vomiting.-FRANK.
A boy, aged 4 years, from eating the seeds, was found sitting
up -in bed, entirely unconscious, with flushed face, restless and
brilliant eyes, widely dilated and rigid pupils, a peculiar and
drunken look; he chattered incessantly without rhyme or reason
and entirely without connection; he frequently sprang upwards
hastily and anxiously, grasped about with his hands, and snatched
at the air; he had no fever and his pulse was sluggish and
slow; still he had a hot perspiration and drank eagerly, but
these arose from his violent muscular exertions and from dryness of his throat. HI-e recovered after free vomiting and purging.-FRANK.
A robust boy, aged 3 years, ate of the seeds; soon after he
complained of scratching in his throat and wished to be put to
bed; he laid down upon his stomach, bored with his head into
the pillow, and his hands and feet commenced to tremble; in
half an hour afterwards he became unconscious and fell into the
most violent spasms; his head was very hot, face dark red, his
limbs redder than natural, his pupils greatly dilated, and he
had profuse salivation; gritting of the teeth, violent trembling,
convulsive attacks and paroxysms of great anxiety sat in, during
which the child constantly exposed his genitals; the abdomen
was distended, but not painful.  Free vomiting and purging,
with cold applications to the head, produced much relief; the
-intense redness of the face and the convulsions abated first, but
the other symptoms persisted, especially the excitement, for the
child continued to sing, scream and moved its eyes and hands
for several hours, until it finally fell into a refreshing sleep, but
the singing and screaming were still present on the next day,
after which he slept for eight hours, and awoke quite restored.
— FRANK.
K




146                   STRAMONIUM.
The leaves produced in four persons: sudden mental derangement,' they made laughable movements, had vertigo, dilated pupils and distended abdomens. —FRANK.
Three cupsful of an infusion of the plant and seeds produced:
nausea and great anxiety; the patient a robust and plethoric
woman was found lying unconscious with closed eyes and mouth,
violent throbbing of the pulse and spasms of the limbs; she
was bled two pounds, when she opened her eyes, and stared
wildly about her; her pupils were widely dilated and insensible
to light and touch; the mouth could be opened, but the tongue
was immoveable and she could utter no sound; the upper part
of the body was drawn backwards spasmodically. Injections
and counter irritation were followed by sleep and perspiration,
with relief from the spasms. —FRANK.
A child, aged 1 years, ate of the seeds, and was attacked
with spasms and distension of the abdomen, followed by unconsciousness.  It was restored by vomiting and purging.FRANK.
A girl, aged 3 years, ate a considerable number of the seeds:
she was attacked with violent convulsions of the arms, paralysis
of the legs, the tongue hung out of her mouth, her eyes were
quite fixed, pupils widely dilated, with muttering and loss of
consciousness. Vomiting and purging were followed by relief;
but on the next day the child complained that it was very dark
and wished candles to be lighted; the pupils still remained
much dilated; she had several bloody stools and finally recovered on the third day. —FRANK.
A man, suffering with rheumatism of the head, took six drops
of the Tincture every two hours, and was apparently cured in a
few days; but he increased the doses three or four-fold, and
was suddenly attacked with heaviness of the head, stupefaction,
inclination to vomit, great debility and dejection, staggering
walk and inability to walk even a few steps, dilatation of the
pupils, dryness of the lips and tongue, violent delirium, hard
and full pulse, and discharge of thin almost spring-water-like
urine. He recovered in a few days and his head-rheumatism
never returned.-FRANK.




STRAMONIUM.                     147
From their tendency to produce eruptions upon the skin, the
internal use of Belladonna and Stramonium may prove as useful as Croton oil or Tartar-emetic ointment applied externally.
Thus, in one case in which the patient was quite stupid, with
quick pulse, hot skin, constant motion of the head, and of
the hands to the head, intolerance of light, &c., and all these
symptoms became gradually aggravated for nine days when a
well-marked eruption of measles appeared with improvement in
all the head symptoms; the child appeared less stupid, somewhat conscious and could more readily distinguish those about
her. In another case of strongly marked cerebral symptoms,
simulating meningitis in a child five years old, where they appeared to depend upon a slight erythematous affection of the
face imperfectly developing itself; there was great restlessness,
high fever, extreme dilatation of the pupils, unconsciousness,
insensibility to light, and incessant rolling of the head from one
side to the other; these symptoms lasted five or six days and
subsided on the appearance of a full eruption from Croton oil on
the back of the neck.
Belladonna and Stramonium may have a homoeopathic relation to a peculiar diagnostic sign in tubercular meningitis, first
announced by TRoussEAu, and which consists in the appearance
of a remarkable red line remaining upon the skin of the forehead, or of the abdomen, after drawing the finger across it. A
female patient of Dr. PARKMAN'S who had scrofulous disease of
the clavicle, was, when about to undergo an operation seized
with a fatal illness, which Dr. P. diagnosed as tuberculous
meningitis, from the peculiar red line spoken of above.
The above remedies are also homoeopathic to'great dryness
of the mouth and nose, and Dr. ROMBERG states that the condition of the nasal mucous membrane constitutes a good diagnostic sign in head-affections; if the secretion be arrested and
the nose be dry, then meningitis is impending. Other signs of
meningitis in infants, are: the continual attempt to bury the
occiput in the pillow, and a frequent change of color in the
cheeks, and especially in one cheek only. Vomiting is often
observed, but with these peculiarities, that it occurred when the
stomach was empty, without nausea, without straining, and was
brought on by moving or shaking the head. The expression of




148                   STRAMONIUM.
the eyes is noticeable; children usually follow with their eyes
the eyes of their attendants; in meningitis they cease to do this.
-ROMBERG.
CASE 84.-A girl, suffering with small-pox and meningitis,
was attacked with convulsive and paralytic symptoms.
Treatmnent.-Tinct.-stram., five drops, in spir.-vini. half an
ounce, removed the dangerous condition instantly.-Arch. 20, 2,
145, GOULLON.
In cases, where during and after an attack of small-pox, the
most violent and most dangerous affections of the brain set in,
accompanied by delirium, STAPF found Stram. in the 12th potency a quick and lasting remedy. —Ibid.
CASE 85.-GRoss observed during the winter season, among
children under seven years, a rheumatic-inflammatory affection
of the meninges, with the following:
Symptoms.-Sleep was not very heavy and soporose, but frequent convulsions of the limbs sat in, attended with groaning;
disturbance of the mind; on awaking there was a peculiar kind
of fatuity; the look was staring, and the child had a desperate
air, gazing fixedly at one point, this state sometimes disappeared slowly, sometimes it passed off with a severe fit of crying, during which the child clung to near objects; the whole
attended with high fever, redness of the face and perspiration.
Stramonium 9. removed this state quickly and completely.Other persons between fifteen and twenty-five years suffered
with extreme absence of mind, they slept little, were taciturn,
did not feel inclined to answer questions, were almost insensible
and immovable, without being unconscious. Spirit.-nitr.-mether.
was more useful than Stramon.-Arch. 9, 2, 140.
REVIEw.-Both experience and the remarks of STAPF, tend
to prove that Stram. in suitable cases, is peculiarly adapted to
inflammation of the meninges. STAPF says Stram. is particularly useful when spasms of the bladder are present.




SULPHUR.                      149
SULPHUR.
GENERAL REMARKS.-a. In the period, says WAHLE, where
the signs of exudation, under the well-known phenomena have
appeared, if Hell.-nig. does not remove the danger in the course
of six or eight hours, we have still a good remedy in Sulph. 30.
and 60. It ought not to be given internally, but a few globules
only should be smelled at. (Ba9h!)-Arch. 15, 2, 23.
b. RUMMEL says, that a physician is frequently not sent for
in diseases of children until convulsions have set in, and these
then mask the real malady which existed previously.  The
principal remedy is, according to his experience, Sulph. 30.
He has used it with good effects even when inflammatory and
exudative affections of the brain were present. If this remedy
produces no good effect, the patient is generally in a hopeless
state; but occasionally he found the previous and alternate use
of Acon. and Bell. somewhat useful. He did not use Sulphur
in any other potency than the 30th, and found it more useful in
the erethistic than in the torpid stage. —Allg. Hom. Ztg., 32,
345.
CASE 86. —Resum6 of the symptoms of inflammation of the
brain in thirteen children, from four to ten years of age; boys
and girls, of whom only one died, on account of too late assistance.
Premonitory Symptoms. —A short time before the beginning of the attack there was observed an insignificant scurf
upon the face, or a little roughness of the chin, ears or face, or
scurfy pustules on the lips. The scurf fell off suddenly, the
pustules dried up quickly and healed. One or two days before
the beginning of the malady the patient had no appetite, with
heaviness of the head, chilliness and debility.
Symmptoms of the Attack.-Soporific sleep disturbed every ten
to twenty minutes by a sudden awaking, with a heavy, audible
crying, ah! ah! or: oh! dear me! or restlessness for several
minutes, followed again by sopor; gnashing of the teeth, vomiting of the food, intolerance of light, constipation, weak and frequent pulse, thirst, dry and white coated tongue, sour smell of
the mouth, redness of the cheeks, or one cheek red, the other




150                     SULPHUR.
pale, perspiration of the head, with a dry, more or less cool skin of
the body; the perspiration of the head emitted a musk-like smell.
Treatment. —Acon. and Bell. without effect. Sulphur -1_3
every six to twelve hours, effected the cure; to one child, Phosphor. -A was given with the best effect.
Course of the Disease.-After giving Acon. and Bellad.;
crying out in the sleep rarely took place, sleep became more
natural, still the child complained about pain of the fore- and
hind-head, as well as about the vertex. From the use of Sulphur and Phosphor., the vomiting ceased, constipation abated,
the symptoms of fever ceased, as well as the heavy sweating of
the head, the skin got moist and a cure followed. Some children were cured after sixteen, others after twelve, and still
others after eight doses.-Arch. 16, 1, 61, WEBER.
CASE 87.-A boy, 2- years of age, was taken sick with the
following:
Sgymptoms. —Head so heavy that it could scarcely be kept
straight and fell to the side; holding it erect produced vomiting
of liquids, or of slime; the child slept most of the time; was
frightened, as if from anxiety; the cheeks changed frequently
from pale to red, or if one was red, the other was pale. The
limbs were cold; there was perspiration only on the head, which
was very hot; thirst; pulse 100.
Treatment.-Acon. vo, ten drops, every two hours, followed by
Bell. 30. after eight hours, without effect.  Afterwards Sulphur 5vvv, every twelve hours. After four doses the child was
perfectly cured, with the exception of great debility.  Bell. 3-~,
removed the weakness within four days.-Arch. 16, 2, 3, WEBER.
CASE 88. —Three cases of inflammation of the brain, in the
persons of a boy, aged three years, and two girls of five years.
SymFtoins. —Could only lay the head in certain situations;
it had to be kept low, otherwise the child would cry and vomit;
deep sleep, interrupted by raving; awaking with a heavy start,
although ordinary calling and speaking would not awaken the
patient; penetrating sour smell of the mouth.
Treatment.-Acon. and Bellad. were of no use, but after
several doses of Sulph. 1500. a cure began instantly.-Arch.
16, 2, 5-10, WEBER.




VERATRUM.                      151
REVIEW.-Of no remedy have we so many observations as
of Sulph.; it proved useful even when the disease was approaching to the second stage, and when Aeon., Bell. and Hellebore
had been given without effect. It was given in high potencies,
the 30th, 60th or 1500th. Among the characteristic symptoms
we do not find the boring with the head, but rather a sinking
down from  heaviness; sweat on the head with a musk-like
smell; changing of the color of the face; sour smell of the
mouth.
The cure was in all cases rapid and progressive.
The doses as above mentioned were all high potencies.
VERATRUM.
CASE 89.-A child, 11 months of age, had on the fifth day
of illness the following:.Symptowns.-It lies slumbering upon its back; eyes half
closed; face pale and thin; it rolled its head violently from
side to side, with sharp screams; or bored into the pillow;
transient redness of the cheeks; throwing off the bed-clothes;
the head when raised fell down backwards, with convulsive motions of the limbs; the eyes were languid and lifeless, with
greatly contracted pupils; the child noticed nothing; its eyes
resembled a dull, gliding glass, covered with a thin transparent
mucus, which dried into hard masses in the corners; it remained
in a torpid state even when spoken to loudly; when it was
raised up it had several convulsive shocks and inclination to
vomit.  At the beginning of the attack there were frequent
paroxysms of vomiting and diarrhoea; the head was hot, the
body almost cool; pulse without strength and of diminished
frequency; it refused to nurse.
Treatment and Result. —Verat.-alb. 2., twenty drops in two
ounces aq. d., a teaspoonful every three hours. At the end of
twenty-four hours after the patient had received three doses,
there seemed little chance of life; but on the fourth day of the
treatment, the patient having taken the Veratrum regularly, the
following state of things was present: when called, the child
cast its eyes to the place where the call came from; the pupils
were of natural size, eyes bright and expressive; the child was




152                 GENERAL REVIEW.
awake almost every hour; has taken the mother's breast; tried
to hold its head up; there were thin discharges from the bowels.
The recovery was soon perfected. —Allg. Hoom. Ztg. 19, 38,
KNOR RE.
Z I N C U M.
GENERAL REMARKS.-In the irritative stage, says HARTMANN, if Bell. is without effect, Zinc. is incomparable in the
second to third triturations; it should be given every two hours.
He has never given this medicine in vain, and generally after
the lapse of twelve to twenty-four hours, the crisis was perfectly formed. —Dess. Therap. 1, 540.
GENERAL  REVIEW,
BY RUECKERT.
The principal remedy was Bell. thirty-seven times. Sulph.
sixteen times. Aconite fifteen times. Bryon. and Opium three
times.  Arn., Hell., Hyosc. and Stram. twice.  Cupr., Digit.,
Iod., Rhus. and Verat. once. Zinc. is recommended.  Opium,
Stram. and Spir.-nitr.-dulc. were frequently used in some epidemics.
Form of inflammation:
1. In encephalitis: Bell., Bry., Hyosc.
2. In inflammation of the meninges: Bell., Bry., Iod., Op.,
Spir.-nitr.-dulc., Strain.
3. In hydrocephalus-acut.
a. In the first stage: Acon.
b.   "   second stage: Arn., Bell., Digit., Hell., Rhus.,
Sulph., Verat.
c. In the third stage: IHelleb.
In order to secure a quick survey of the principal indications,
we:append the annexed synopsis.
During and after acute exanthems, such as scarlet fever or
measles, when inflammation of the brain appeared, Arn., Bell.,
Cupr. —From dentition, Aeon., Cupr.-During febrile catarrh,
Cupr.-After sun-stroke, -Bell.-During and after small pox,




GENERAL REVIEW.                    153
Stram. Reports of cases have been contributed by thirty-eight
physicians.
DosEs.-The strong tincture was only used in a few cases;
from the first to the third potencies 35 times, viz.: 5 times in
drop doses, 14 times in single doses, and 15 times in solution
and repeated doses. From the fourth to the high potencies
were used in 58 cases. 24 times but one remedy was given, 10
times single doses, 7 times in solution, 17 times in high potency
in repeated doses. Of the cases in which one remedy alone
proved successful: Aeon. was given in 3 cases.
Bell. "    "  " 21 
Bryon."    "  " 1 case.-25 cases.  To
these we may add the 16 cases treated with Sulph., in which
Aeon. and Bell. were given without effect; 16, without regarding many other cases in which other remedies were given without effect, thus we have in whole 41 cases cured by one remedy.
These cases deserve sufficient attention to encourage us to attempt to cure without a sudden change of remedies. In general
we may say that 12-children were cured by taking Sulph. Some
required 16, others 12, others eight doses to effect a cure.
Among 18 cases:
In 10 the cure was effected in from 4 to 12 hours.
"  6                            5 to 24  "
"  2   "                    "     3 to 5 days.
A complete cure was effected in 30 cases;
23 times in from 1 to 5 days.
6'"    "    6to12"
once in 4 weeks.
Most of the cases, after the dangerous signs had ceased, were
cured gradually without particular crisis. In 7 cases there was
a quiet, many hours' lasting sleep; in 5 cases sweat; in 2 cases
diarrhoea; in 2 cases boils; in 2 cases discharge from the ears;
in one case a loose cough.
L




154                          SPECIAL INDICATIONS.
SPECIAL INDICATIONS.
Zs;Z:       c~ o     2        4l t1
Headache, violent  and
piercing,..                       Bry.
In the head, like swinging,..  Bell Bry.                           Rhus.
Head warm and body cold,                                                           Vera.
Heat of the head.........     Bell.lBry.    Dig.. 
Sweat of the head, smell-....
ing like musk........                       ISulp.
Boring with the back of.. 
the head.............. Ac.    Bell....                             Str      Vera.
Fluctuating,.falling back..
of the head........     Bll.. Cup Dig. Hell...... Rhus.              Vera.
Head, violent turning in,..Vera.
Face, red...........      Bell Bry.Hyos.                             Sr.' bright, nearly brown,..         Bry....       Str.
slightly red..........
Cheeks red,........         B........
Face hot...................    Bell.....
pale...............  Bell.            iHell.....
changing color,..... Ac......... Sulp.
Eyes rolling, turning,.....Ac   Bell          D Dii. Hell.....
squinting............  Arn. Blell..    ig.I.ell.....
staring.............       Bell          ig.                         Sr.
"  half open..........l..  Beil.l Bry.     ig.Hell. yos....                  Vera,
sparkling,,........        Bell.......
"dim, weak...........        Bell.. Hell. lyos....         Vera.
Eyelids, edematous....                                              Rhus.
Pupils enlarged,.....,...   A.. rn  Bell      ig Hell Hyos. 
contracted,.      Ac.    Bell.                             op.. Sulp.Vera.
Tongue, dry............Ac.    Bell Bry.   Sulp.
white coated,..         Bell... Sulp.
Sour smell of the mouth,... Sulp.
Great thirst............c.     Bell Bry.     Dig.... Sp.
Gnashing of the teeth.Bl....       l... BSnpul.
Vomiting,..........  Ac.    Bell.. Cup.... Hyos... Op.. Sulp.
on rising, up, Ac. Bell...
Abdomen,  painj'ul  and         B
swollen................      Bell Bry.              Hyos
Stool, hard, wanting....        Bell. Bry..  Iig..                            S up.
involuntary,..Bell.                         Hell..
Urination involuntary,...       Bell.             Hell...
Breathing, anxious, groan-.                                         i
ing........Arn. Bell Bry.Hyos....
Breathing quickened...          Bell                  1Byos.
Pulse, quick, weak.......    Arn. Bell...       ell... Sulp.
full, hard.......... Ac     Bell.
"   trembling,  intermittin,.........                         H  ell...        hus.
"   scarcely percepti-..
ble..............                                           Rhus.
Beating of the carotids,.        B i    B..ell
Convulsive fits.......... m. Irn Bell.... Dig. ell......
Tremblina of the limbs,..        B ell.Hell.                              l
Graspina with the hands..
at the head.............. Ac.    Bell..'   IHell...
Cramps,................          ell....... iyos.. Rhus. Str.
Inclination to paralysis.... RhusiSr.
Heat, general...... Ac...Bell....
Skin, dry, hot..............  Bell          Dig.      l tyos.....
Sleep, with snoring....          eli.                           Op.
starting....Ac.    Bell. Bry.Rhus.  iSulp
gnashing  of
the teeth.......... Aci. Bell..........      Sulp.
Inclined to sleep, but not
able,.................             ry. Cup
Sopor....................                    ig.      p1.Rhus. Sr Sp..
Delirium................Ac      BellBry.'Hyos Iod.          Str.
Passionate..............Bry..
Stupid...'...............           ICup.. Hell.            Op...  Str.
Inclination to run away,. Ac.  Bell.... Hell..
Inclination to run  away,.f     ~~ ifell.  i" 1"  /Hell'[  "1"  1" ["~    1"  /"   |"




I N D E X.
A.
[PAGE
Atrophy of the Brain............................................... 52
Acute and general Inflammation of the Brain,;.................           65
Abscess of the Brain,......................................              6
Aconite,...........................................................  79
"6    General Remarks,..............................    79
"  Cases,.......................... 82
Doses...85
Arnica  Doses,....................................I...............  86
Arnica,..86
Arsenicum,........................................................  87
B.
Belladonna,......................................................  88
"     General Remarks,...........  88
"   Cases,................................. 90
Doses................................................... 103
Bryonia,.... 104
C.
Congestion of the Bratin,..................... 4
Cancer........................7.                 77
Cuprum,......................................7..             107
D.
Digitalis. ~~~~~.~0~~~.~.~~~~~  ~..~~~~..~~0~~0~0.~  ~~~~~~~~~~~~~0~~ 111
F.
Fully developed Tuberculous Meningitis...............................34
G.
General Review,                                                           152
General  Etevi wct~,.......................................           152
H.
Helleborus-niger....................................................  117
Hydrocephaloid Disease.............................................  49
Hypertrophy of the Brain......................................... 53




156                                 INDEX.
PAGE
Hydrocephalus.....................................................   57
"c  Internal,.............,....., 57
"    Chronic........................................ 58'"      External,.................. 62
Hydatids of the Brain,................,,,,..   68
Hyosciamus........................................................ 122
Hydriodate of Potash,...........................,,,........,.   127
I.
Irritation of the Brain,..............,,1
Inflammation of the Dura Mater....................................;   10
"4    " Arachnoid.................15
It'" Pia Mater,.................. 17
Iodine,................1....,...............................  127
N.
Natural Cures,..........,,.,,..., 135
0.
Opium,.......................................................  139
R.
Rhus-toxicodendron................................................. 142
S.
Stramonium,...........................,.......................... 144
Sulphur........................................................... 149
Special Indications,............................ 154
T.
Tubercular Meningitis,........................ 24
Tubercle,.................... i.................................  27
Tuberculous Blood,.............................................   29
"c      Dyscrasia,..........2..................  29
le           "    Dietetic Treatment of,..................      29
it      Indigestion,................................, 32
Tubercles of the Brain.............................................  70
V.
Veratrum,...............................                                     151
Z.
Zincum........................................................... 152