CHINA

(Cinchona Bark.)

(From vol. iii, 2^nd edit., 1825.)

(The alcoholic tincture of the thin tubular as well as the royal bark, Cinchona officinalis.)

Excepting opium I know no medicine that has been more and oftener misused in diseases, and employed to the injury of mankind, than cinchona bark. It was regarded not only as perfectly innocuous, but as a wholesome and universally beneficial medicine in almost all morbid states particularly where debility was observed, and was often prescribed in large doses several times a day for many weeks, and even months, together.

In so acting the ordinary physicians were guided by an utterly false principle, and they confirmed the reproach I have already frequently made against them to the more sensible portion of the public, that they have hitherto sought in traditional opinions, in guesses prompted by false lights in theoretical maxims and chance ideas what they could and should find only by impartial observation, clear experience, and pure experiment, in a pure science of experience such as medicine from its nature must only be.

Setting aside all guess-work and all traditional unproved opinions, I adopted the latter method, and I found, as with the other medicines, so especially with cinchona bark, by testing its dynamical powers on the healthy human being, that has certainly as it extremely curative in some cases of disease, so surely can it also develop the most morbid symptoms of a special kind in the healthy human body; symptoms often of great intensity and long duration, as shown by the following true observations and experiments.

Thereby, first of all, the prevailing delusion as to the harmlessness, the child-like mildness and the all-wholesome character of cinchona bark is refuted. (As long ago as the year 1790 (See W. CULLEN’s Materia Medica, Leipzig, bei Schwickert, ii, p. 109, note) I made the first pure trial with cinchona bark upon myself, in reference to its power of exciting intermittent fever. With this first trial broke upon me the dawn that has since brightened into the most brilliant day of the medical art; that it is only in virtue of their power to make the healthy human being ill that medicines can cure morbid states, and indeed, only such morbid states are composed of symptoms which the drug to be selected for them can itself produce in similarity on the healthy. This is a truth so incontrovertible, so absolutely without exception, that all the venom poured out on it by the members of the medical guild, blinded by their thousand-years old prejudices, is powerless to extinguish it; as powerless as were the vituperations launched against HARVEY’s immortal discovery of the greater circulation in the human body by RIOLAN and his crew to destroy the truth revealed by HARVEY. These opponents of an inextinguishable truth fought with the same despicable weapons as do to-day the adversaries of the homoeopathic medical doctrine. Like their modern congeners they also refrained from repeating his experiments in a true, careful manner, (for fear lest they might be confused by facts), and confined themselves to abuse, appealing to the great antiquity of their error (for GALEN’s predecessors and GALEN himself had arbitrarily decided that the arteries contained only spiritual air, and that the source of the blood was not in the heart but in the liver), and they cried out: Malo cum Galeno errare cum Harveyo esse circulator! This blindness, this obstinate appeal to the extreme antiquity of their delusion (it was only after thirty years and more that HARVEY had the satisfaction of seeing his true doctrine universally adopted), was in those days not more stupid than the blindness of to-day, and the present aimless rancour against homoeopathy which exposes the pernicious rubbish talked about ancient and modern arbitrary maxims and unjustifiable practices, and teaches that it is only by the responses given by nature when questioned that we can with sure perscience change diseases into health rapidly, gently, and permanently. )

But equally evident is it, from the symptoms of disease produced by cinchona bark in healthy observers recorded below, that the numerous unhappy results of the treatment by this bark occurring in the practice of ordinary physicians, and the frequently incurable aggravations of disease developed where bark in long continued and large doses was the main remedy in the prescriptions were owing solely to the noxious character of this drug when employed in unsuitable cases, and in too frequent and too large doses. This noxious character is demonstrated by the medicinal symptoms recorded below, which physicians till now were not aware of, and which they made no effort to ascertain. On the contrary, they innocently ascribed these aggravations to the natural course of the disease itself.

But I refrain from blaming these physicians, whose judgement is biassed by the prejudices of their schools, on this account, (their conscience will doubtless reproach them for it) I will content myself with expressing my own convictions in a few remarks.

1.Cinchona bark is one of the most powerful vegetable medicines. When it is accurately indicated as a remedy, and when the patient is seriously and intensely affected by a disease that china is capable of removing, I find that one drop of a diluted tincture of cinchona bark, which contains a quadrillionth (1/ 1000000,000000,000000,000000,th) of a grain of china-power, is a strong (often a too strong) dose, (Compare this with the large doses of this drug given in ordinary practice!) , which can accomplish and cure all alone all that china is capable of doing in the case before us; generally without it being necessary to repeat this dose in order to effect a cure; a second dose being rarely, very rarely, required. In the case neither of this nor of any other medicine did a preconcieved opinion or an eccentric fancy lead me to this minuteness of dose. No, multiplied experience and faithful observation led me to reduce the dose to such an extent. Led by experience and observations I clearly saw that larger doses, even where they did good, acted much more powerfully than was needed for the cure. Hence the smaller doses; and as I repeatedly observed from these the same effects though in a less degree, I gave still smaller, and the very smallest doses. These proved sufficient to effect a complete cure, and they did not display the violence of larger doses, which tends to delay the cure.

2. A very small dose of china acts for but a short time, hardly a couple of days, but a large dose, such as is employed in the practice of every day, often acts for several weeks if it be not got rid of by vomiting or diarrhoea, and thus ejected from the organism. From this we may judge how excellent the ordinary practice is of giving every day several and moreover large doses of bark!

3. If the homoeopathic law be right – as it incontestably is right without any exception, and its derived from a pure observation of nature – that medicines can easily rapidly, and permanently cure cases of disease only when the latter are made up of symptoms similar to the medicinal symptoms observed from the administration of the former to healthy persons; then we find, on a consideration of the symptoms of china, that this medicine is adapted for but few diseases, but that where it is accurately indicated, owing to the immense power of its action, one single very small dose will often effect a marvellous its action, one single very small dose will often effect a marvellous cure.

I say cure, and by this I mean a “recovery undisturbed by after-sufferings”. Or have practitioners of this ordinary stamp another, to me unknown, idea of what constitutes a cure? Will they, for instance, call cures the suppression by this drug of agues for which bark is unsuited? I know full well that almost all periodic diseases, and almost all agus, even such as are not suited for china, must be suppressed and lose their periodic character by this powerful drug, administered as it usually is in enormous and oft-repeated doses; but are the poor sufferers thereby really cured? Has nottheir pervious disease only undergone a transformation into another and worse disease, though it may no longer manifest itself in intermittent attacks recurring periodically, but has become a continued and, we may say, a more insidious disease by this very powerful and, in this case, insuitable medicine? True, they can no longer complain that the paroxysm of their original disease reappears on certain days and at certain hours; but note the earthy complexion of their puffy faces, the dulness of their eyes! See how oppressed is their breathing, how hard and distented is their epigastrium, how tensely swollen their loins, how miserable their appetite, how perverted their taste, how oppressed and painful their stomachs by all food, how indigested and abnormal their faecal evacuations, how anxious, dreamful, and unrefreshing their sleep! Look how weary, how joyless, how dejected, how irritably sensitive or stupid they are as they drag themselves about, tormented by a much greater number of ailments than afflicted them in their ague! And how long does not such a china-cachexy often last, in comparison with which death itself were often preferable!

Is this health? It is not ague, that I readily, that I readily admit; but confess – and no one can deny it – it is certainly not health. It is rather another, but a worse, disease than ague. It is the china-disease, which must be more severe than the ague otherwise it could not overcome and suppress (suspend) the latter.

Should the organism, as it sometimes will, recover from this china disease after many weeks, then the ague, which has till now remained suspended by the superior force of the dissimilar china-disease, returns in an aggravated form, because the organism has been so much deteriorated by the improper treatment.

If the attack be now renewed in a still more energetic manner with cinchona bark, and continued for a longer time in order, as it is said, to ward off the fits, there then occurs a chronic china-cachexy, a faint picture of which will be found in the symptoms recorded below.

Such are most of the bark treatments of our physicians, because they know not what are the cases for which bark is suited. They are suppressions of the original affection by the production of a stronger china-disease, which is mistaken for a manifestation of the obstinacy of the original disease, the development of new symptoms being attributed to its peculiar malignity; because it is not known that these ailments are due to china, because it is not recognised what they are, namely, artificially induced china-disease.

The following symptoms caused solely by bark acting on the healthy body, will open the eyes of physicians on this subject, those of them at least who have not yet acquired the faculty of silencing their consciences, and in whose bosoms a warm heart for the welfare of their fellow creatures still beats.

Most intolerable and unjustifiable, however, is the monstrous abuse made by the dominant school of medicine, which plumes itself on being the only rational school, of this powerful drug in all kinds of debility.

There is no disease which is attended by weakness (as almost every one is naturally), or which physicians by their unsuitable allopathic medicinal mixtures have reduced to exhaustion of vital powers – where they did not consider it necessary to give this bark in large doses in order to strengthen as they call it; no patient prostrated, ruined and enfeebled by improper drugs to a condition of complicated cachexy whom they have not endevoured to set up and restore to a healthy condition by tonic potions of infusion, decoction, extract, electuary of china, or by the same drug in powder. He is stuffed and tortured with it for weeks and months under the pretence that it will do him good. Of the consequence of such treatment I would prefer to say nothing. If the death-rolls could speak, they would most eloquently speak the praises of this abuse of bark; and so also would the crowds of the living victims of asthmatic, dropsical, and icteric diseases, and those other unfortunates who remain affected with neuralgic os spasmodic maladie, or with malignant growths, abdominal sufferings or lingering fever, if they but knew what mischief had been done to them.

I would appeal to the common sense of these practitioners and ask them how, without being guilty of the most unpardonable slipshod practice, they can venture to administer bark in all those infinitely various diseases, which of themselves, as also especially in consequence of the traditional medical treatment, must necessarily medical be attended by weakness? How can they ever imagine that they can strengthen a sick person whilst he is still suffering from his disease, the source of his weakness? Have they ever seen a patient rapidly cured of his disease by appropriate remedies who failed to recover his strength in the very process of the removal of his disease? If, however, as is natural, it is only by the cure of the disease that the weakness of the patient can cease and give place to strength and activity, and if, on the other hand, there can be no question of a removal of the weakness as long as its source is not dried up, that is to say, as long as the disease on which it depends is not cured, what a perverse treatment must not that be, which seeks to make strong and active by the administration of china (and wine) a patient at whose vitals the disease is still gnawing! These practitioners cannot cure diseases, but they can attempt to strengthen these uncured patients with cinchona-bark. How can such a stupid idea ever enter their heads? If bark is to make all sick persons strong, active and cheerful, it must needs be the universal panacea which shall at once deliver all patients from all their maladies, from all morbid sensations and abnormal functions, that is to say, make them in all their ailments in every respect well and free from disease! For so long as the plague of disease deranges the whole man, consumes his forces and robs him of every feeling of well-being, it is a childish, foolish, self-contradictory undertaking to attempt to give such an uncured person strength and activity.

That cinchona-bark is no panacea for all diseases, we are taught by the sad experience of the ordinary practice; but its symptoms show that it can be an appropriate, real remedy for only a few cases of disease.

It is no doubt true that by the first doses of bark the strength of the patient, be he ever so ill, is increased for a few hours; he is able to raise himself up in bed all alone, as if by a miracle; he wants to get out of bed and put on his clothes; all at once he speaks in a stronger more resolute manner, venturing to walk alone, and grows animated, eagerly desires to eat this or that,- but a careful accurate observer easily sees that this excitation is only an unnatural tension (see below the note to § 895). A few hours pass and the patient sinks back, sinks deeper down into his disease, and the fatal result is often accelerated.

Do not these gentlemen perceive that no one can become well (truly strong and active) as long as his disease lasts?

No! the always suspicious semblance of strength communicated to the patient for a few hours by bark is invariably attended by the saddest results, and this will ever be so, except in those rare cases where cinchona-bark is at the same time the right remedy for the disease on which the weakness depends. In such cases the patient’s weakness ceases immediately with the disease. But, as I have said, such cases are rare, for cinchona-bark is the true remedy (which relieves rapidly, permanently, and without after-ailments) for but few diseases. In all the many other cases bark, as a medicine and so-called tonic, must to harm, and the more so the stronger its medicinal power (injuring when given improperly) is. For all medicines, without exception , can do no good when unsuitable for the case of disease, and must inflict so much the more injury the greater their medicinal strength (and the larger the doses in which they are given).

Hence, physicians should first learn the peculiar power oaction of cinchona-bark, and exactly what particular alterations in the health of human beings it is capable of causing, before they presume to undertake the cure of diseases, and consequently the morbid weakness, with this powerful medicinal agent. They should first know the symptoms of china before attempting to determine for what collection of morbid symptoms, that is, for what case of disease it may be curative; it can be curative for none but those whose symptoms are to be found in similarity among the symptoms of china, he who falls to do this will always commit mistakes, and do infinitely more harm than good to the patient.

When china has been selected according to conscientious homoeopathic conviction (but not as hitherto, according to theoretical views, deceptive names of diseases, or the misleading authority of equally blind predecessors), and is consequently the truly appropriate remedy of the case of disease to be treated, in such a case, and for that very reason, it also the true strengthening remedy. It strengthens in as much as it removes the disease, for it is only the organism free from disease that restores the defective strength; strength cannot be materially poured into it by a decoction of china (or by wine).

There are no doubt cases where the disease itself consists of weakness, and in such cases bark is at once the most appropriate curative and strengthening remedy. Such a case is that where the sufferings of the patient are solely or chiefly owing to weakness from loss of humours, from great loss of blood (also from repeated venesections), great loss of milk in nursing women, loss of saliva, frequent seminal losses, profuse suppurations (profuse sweats), and weakening by frequent purgatives, where almost all the other ailments of the patient are wont to correspond in similarity with the china symptoms (see notes to 837 and 860). If, then, there is here no other disease in the background to produce dynamically or to keep up the loss of humours, then for the cure of this peculiar weakness (from loss of humours), which has here become the disease, one or two doses as small as those above mentioned, (Here as elsewhere I insist on the sufficiency and efficiency of such small doses. And yet the vulgar herd can never understand me, for they know nothing of the pure treatment with one single simple medicinal substance to the exclusion of all other sorts of medicinal irritants, and their thoughts are enchained in the mazes of their old routine. Even when the ordinary physicians now and then constrain themselves to give in some (acute) disease one single medicine, they never have the heart to refrain from using at the same time several other things possessing medicinal power, which, however, they regard as of no consequence, and to which they apply the trivial name of domestic remedies.) They must always use simultaneously either a poultice of so-called aromatic or solvent herbs applied to the most painful part(just as though these could have no effect on the patient through his olfactory nerves, nor act as a heterogeneous medicine through the skin!), or they must rub in some medicinal ointment, or give a medicinal vapour-bath, or a medicinal gargle, or apply a blister or sinapism, or prescribe several half, whole or foot-baths, or order clysters of valerian, camomile, &c. (just as though all these were a mere nothing and did not act on the human system as heterogeneous powerful medicine through the skin, the mouth, the rectum, the colon, &c.!), or they must administer simultaneously a tea of mint camomile, elder-flower, so-called pectoral herbs, &c. (Just as though a handful of such herbs or flowers infused in boiling water counted for nothing!). In such an onslaught with heterogeneous drugs, which, although ignorance looks upon them as innocuous domestic remedies, are to all intents and purposes medicines, and some of them very powerful medicines, in this accessory quackery, I say, even a large dose of medicine of another kind can, of a truth, never display its peculiar action, and such an uncommonly small dose as homoeopathy requires is completely powerless; it will be instaneously overpowered and aniihilated. No! in the language of rational men that alone can be called giving a single medicine in a disease, when, excepting this one, all other medicinal influences aer excluded from the patient and carefully kept away from the patient and carefully kept away from him. But he who will do this must know what things brought in contact with the human body act medicinally on it. So long as he does not know this it must be ascribed to his ignorance that he considers as nothing, as not at all medicinal, such things as herb-teas and clysters, poultices and baths of herbs and salts, and the other things just mentioned, and continues to use them thoughtlessly under the name of domestic remedies during the employment of medicine internally. Still more heedlessly in this respect is the treatment of chronic maladies conducted; for, in addition to what the patient takes from medicine chests and bottles, and the external applications and so-called domestic remedies that are usually administered to the patient, lots of superfluous hurtful things are allowed, and even prescribed, which are also regarded as indifferent matters in spite of the disturbing effects they may exercise on the patient’s health, and of the confusion they may cause in the treatment. Besides the internal and external use of medicines the patient is allowed, for example, to take (fro breakfast) mulled beer, vanilla chocolate, also (even several times a day) strong coffee or black and green tea, not unfrequently – to strengthen the stomach (?) – claret-cup, liqueurs containing strong spices, seasonings of all sorts in the food, and especially in sauces (made of soy, cayenne pepper, mustard, &c.) – these things are supposed merely to increase the appetite and promote digestion, but to possess no hurtful medicinal quality! – moreover, quantities of uncooked herbs cut small and sprinkled over the soup – which are regarded as supremely wholesome, but are really medicinal – also various sorts of wine – one of the main reliances of ordinary practice – must not be forgotten. Besides all these there are tooth-powders, tooth-tinctures, and tooth-washes - also composed of medicinal ingredients, and yet considered innocuous because for-sooth they are not swallowed; just as though medicines only taken into the mouth or their exhalations drawn into the nose did not as surely act on the whole organism through its living sensitive fibres as when they are swallowed! And then the various kinds of perfumes and washes (musk, ambergris peppermint drops, oil of bergamot and cedar, neroli, eau-de-Cologne, eau-de-luce, lavender water, &c.), besides perfumed sachets, smelling bottles, scented soaps, powders and pomades, pot-pouri, and any other noxious articles de luxe the patient may desire. In such an ocean of medicinal influences the otherwise adequate homoeopathic dose of medicine would be drowned and extinguished. But is such a medley of medicinal luxury necessary and useful for the life and well-being or compatible with the recovery of the patient? It is injurious; and yet, perhaps, it has been invented by physicians themselves for the upper classes in order to please, to stimulate and to keep them ill.but even though physicians may not directly recommend it, it is sufficiently sad that they not know the medicinal noxiousness of all this luxury, and that they do not prohibit it to their chronic patients, This hotch-potch of noxious influences, due partly to the luxurious habits of the patient himself, partly to the simultaneous use of domestic remedies ordered or permitted by the doctor, is so much the rule, so universally pervalent, that the ordinary practitioner cannot think of treatment without such a simultaneous medical confusion, and hence, under these circumstances, he is unable to promise any decided effect from the internal administration of a single medicinal substance in a disease, even when it is given in a large dose, far less from a very small dose of medihomeopathically employed! CONRADI was acquainted with no other treatment than such as is constructed amid such a confused medley of medicinal influences, as is evident when he says (Grunariss der Pathologie and therapie, Marburg, 1801, p. 335), that the action ascribed by me to such small doses is beyond all belief. Here, not to dwell upon the trifling circumstance that the determination of the action of medicinal doses is hardly a matter of belief, but rather of experience, he seems no more than other ordinary practitioners to have either the slightest conception or the slightest experience of the action of a small dose of appropriate medicine in a patient completely excluded from the simultaneous irritation of all other kinds of medicinal substances, otherwise he would have spoken in a different manner. A pure treatment with a single homoeopathic medicine, all counter-acting medicinal contaminations being removed (for it is only of such I speak and only such I teach), never is seen or dreamt os in routine practice. But the difference is enormous and incredible.

So the glutten just risen from his luxurious meal of highly-spiced food is incapable of perceiving the taste of a grain of sugar placed upon his over-stimulated tongue; whereas a person contented with simple fare will, when fasting in the morning, experience an intense sweet taste from a much smaller quantity of the same sugar. Similarly amid the multifarious noises in the most crowded part of a large town we can often not comprehend the loudly spoken words of a friend at the distance of five or six paces, whereas in the dead of night, when all the sounds of day are hushed and perfect stillness prevails, the undisturbed ear distinctly perceives the softest tone of a distant flute, because this gentle sound is now the only one present, and therefore it exercises its full action on the undisturbed organ of hearing.

So certain is it, that when all accessory medicinal influences are withheld from the patient (as should be done in all rational treatment), even the very minute doses of a simple medicinal substance, especially of one chosen according to similarity of symptoms , can and must exercise its adequate and complete action, as a thousand-fold experience will teach any one whom prejudice does not deter from repeating the experiment accurately.

Quite small doses of medicine are all the less likely to fail to exercise their peculiar action, in as much as their very smallness cannot excite the organism to revolutionary evacuations (what is morbid in the organism is altered by the small dose), whereas a large dose, by the antagonism it excites in the system, will often be rapidly expelled and bodily ejected and washed away by vomiting, purging, diuresis, perspiration, &c.

Will the ordinary physicians at last understand that the small and smallest doses of homoeopathically selected medicines can only effect great results in a pure genuine treatment, but are quite unsuitable in routine treatment?) together with appropriate treatment in other respects, by nourishing diet, open air, cheerful surroundings, &c, are as efficacious to effect recovery as larger and repeated doses are to cause secondary and injurious effects, as is the case with every nimium, every excess even of the best thing in the world.

This suitableness of cinchona-bark in diseases of debility from loss of humours led physicians of the ordinary sort, as it were instinctively, to a mode of treatment of many diseases which has been, and still continues to be, the most prevalent of all modes of treatment – the weakening treatment by means of squandering the humours (under pretence of loosening the morbid matter and expelling it from the body) by means of frequently repeated so-called solvents (that is, drugs of various kinds that purge the bowels), by means of exciting an increased flow of urine and copious perspirations (by many tepid and warm drinks and quantities of tepid and warm-bath), by means of blood-letting by venesection and leeches, by means of salivation, by means of drawing off imaginary impure humours by open blisters, issues, setons, &c. If such a treatment, especially that by mild purgatives the use of which is so general, be long enough continued, then, by means of irritation of the intestinal canal, not only is the greater disease of the abdomen that keeps in suspense the acute disease, so long kept up until the natural termination of the acute disease is reached, but also a disease of debility from loss of humours is induced, for which, then, after months of treatment, when the strength and humours are much exhausted, cinchona-bark will assuredly restore the health in the only remaining malady (the artificially produced disease of debility from loss of humours). But none perceived by what a circuitous round-about way such a cure was affected. Thus, inter alia, the spring tertian fevers, and most other diseases of an acute character, having of themselves a duration of only a few weeks, are spun out into (rational?) treatments of many months’ duration; and the ignorent patient is happy in having escaped with his life, whereas a real cure of the original disease ought only to have occupied in a few days.

Hence the everlastingly repeated warnings in so-called practical works, not to administer cinchona-bark in agues, until all the (imaginary)impurities and morbid matters have been energetically and repeatedly evacuated upwards and downwards, or, according to the euphemistic expressions of the moderns (though the same thing is meant), until the solvent treatment (i.e. laxatives and purgatives to produce many liquid stools) has been employed to a sufficient extent and long enough; in reality, until the artificially produced abdominal disease has lasted longer than the normal duration of the ague, and so the disease of debility from loss of humours which alone remains can be transformed into health by cinchona-bark, as of course it will be.

This is what was and is still called methodical and rational treatment, in many, many cases of disease.

With equal justice might we rob widows and orphans in order to establish as asylum for the poor.

As cinchona-bark in its primary action is a powerful laxative (see the symptoms, 497 et seq.) it will be found to be very efficacious as a remedy in some cases of diarrhoea when the other symptoms of china are not inappropriate to the rest of the morbid symptoms.

So also in those cases where we have to do with so-called moist gangrene in the external parts, we shall generally notice in the remainder of the patient’s ailments, morbid symptoms similar to the symptoms peculiar to cinchona-bark; hence it is so useful in such cases.

The too easy and too frequent morbid excitation to seminal discharges of the genitals, caused sometimes by slight irritation in the hypogastrium, is very permanently removed by the smallest dose of bark (in conformity with its peculiar symptoms of this character).

Those attacks of pain which can be excited by merely touching (or slightly moving) the part and which then gradually increase to the most frightful degree are to judge by the patient’s expressions, very similar to those caused by china. I have sometimes permanently removed them by a single dose of the diluted tincture, even when the attacks had been frequently repeated. The malady was homoeopathically (see note to 685), as it were, charmed away, and health substituted for it. No other known remedy in the world could have done this, as none other is capable of causing a similar symptom in its primary action.

Bark will hardly ever be found curative when there are not present disturbances of the night’s rest similar to those the medicine causes in the healthy (which will be found recorded below).

There are some, though but few, suppurations of the lungs (especially accompanied by stitches in the chest, almost always only aggravated or excited by external pressure), that may be cured by bark. But in these cases the other symptoms and ailments of the patient must be found similarity among the symptoms of china. In such cases only a few, sometimes but a couple of doses of above minuteness, at long intervals, suffice for the cure.

So also there are a few icteric diseases, of such a character that they resemble the symptoms of china ; when this is the case the disease is removed as if by magic by one, or at most two, small doses, and perfect health takes its place.

An intermittent fever must be very similar to that which china can cause in the healthy, if that medicine is to be the suitable, true remedy for it, and then a single dose of the above indicated minuteness relieves – but this it does best when given immediately after the termination of the paroxysm, before the operations of nature are accumulated in the body for the next fit. The usual method of suppressing an ague not curable by cinchona bark, by means of large doses of this powerful substance, is to give it shortly before the paroxysml it is then most certain to produce this act of violence, but its consequence are very injurious.

Cinchona-bark can only permanently cure a patient affected with intermittent fever in marshy districts of his disease resembling the symptoms of china, when the patient is able to be removed from the atmosphere that causes the fever during his treatment, and until his forces are completely restored. For if he remain in such an atmosphere he is constantly liable to the reproduction of his disease from the same source; and the remedy, even though frequently repeated, is unable to do any further good; just as the morbid state induced by over-indulgence is coffee is rapidly relieved by its appropriate remedy, but while the hurtful beverage is continued to be taken, it will recur from time to time.

But how could physicians act so stupidly as to think of substituting other things for cinchona-bark, which in its dynamic action on the human health, and in its power to derange that health in a peculiar manner, differs so immensely from every other medicinal substance in the world? (See the peculiar symptoms it causes, recorded below.) How could they dream of finding a surrogate for china, that is to say, a medicinal substance of identical and precisely the same medicinal power among other extremely different substances? Is not every kind of animal, every species of plant, and every mineral something peculiar, as entity never to be confounded, not even in external appearance, with any other? Could any one be so short-sighted as from their external appearance to mistake a cinchona tree for a willow tree, an ash or a horse- chesnut? And if we find these plants differ so much in their external characters, though nature cannot offer so much difference to a single sense – that of vision – as she can, and actually does, to all the senses of the practised observer in the dynamic action of these various plants on the health of the living healthy human organism, shall no attention be paid to these latter, the multiform peculiar symptoms which each single one of these plants elicits in a manner so different from those of the second and third, and whereon alone depends the specific medicinal power of each medicinal plant with which only we are concerned in curing disease? Shall we fail to perceive their high significance, shall we fail to recognise them as the highest criterion of the difference of drugs among one another? Or shall we consider all things that have a bitter and astringent taste as identical in medicinal effects, as a kind of cinchonabark.(As W. CULLEN amongst others does (See Abh. uber die Matria Medica, ii, p. 110, Leipz., 1790.) and thus constitute the coarse sense of taste in man (which power) the supreme and sole judge for determining the medicinal significance of the various plants? I should think it were possible to act in a more short-sighted and foolish manner in matters of such extreme importance for the welfare of humanity!

I grant that all the medicinal substances that have been proposed as substitutes for cinchona-bark, from the lofty ash down to camomile and lichen on the wall, as also from arsenic down to Jame’s powder and sal-ammoniac, I grant, I say, that every one of those medicinal substances I have named, and others I have not named, has of itself cured particular cases of ague (their reputation proves they have done this now and then). But from the very circumstance that observers state of one or other that it was efficacious even when cinchona bark did no good or was hurtful, they prove clearly that the ague which the one medicine cured was of a different kind from that other cured! For had it been an ague suited for china, this medicine must have removed it, and none other could have been of use. Or else there must be foolishly attributed to the china in this case a peculiar malignity and spitefulness, making it refuse to be helpful, or to the other vaunted medicine, which was efficacious, a peculiar amiability and obligingness, causing it to do as the doctor wished! It would almost appear as if some such foolish notion was entertained!

No! the truth of the matter, which has not been perceived, is as follows: It is not the bitterness, the astringent taste, and the so-called aroma of the cinchona bark, but in its whole intimate nature, that resides the invisible dynamical working spirit, that can never be exhibited in a material separated condition (just as little as can that of other medicinal substances), whereby it differentiates itself from all other medicines in the derangements of the human health it causes. See the observations recorded below.

Everyone one of the medicinal substances recommended in agues has its own peculiar action on the human health, differing from the medicinal power of every other drug, in conformity with eternal immutable laws of nature. Every particular medicinal substance, by the will of the Creator, differs from every other one in its externals (appearance, taste, and smell), and even much more so in its internal dynamic properties, in order that we may be enabled by means of these differences to fulfil all possible curative intentions in the innumerable and various cases of disease. Is it to be supposed that the all-good and omnipotent Creator of thew infinite varieties of nature could, would, or should have done less?

Now, if everyone of the vaunted ague remedies, whilst leaving other agues uncured, has really cured some cases – which I will not deny as far as regards those cases where the observers have given the remedy by itself – and if every single one of these remedies has affected its cure, not as a matter of especial favour towards the doctor who prescribed it, but, as it is more rational to suppose, owing to a peculiar power bestowed on it in conformity with eternal laws of nature, then it must necessarily be that the case in which this remedy, and not another, did good, was a peculiar form of ague, adapted for this medicine only, and different from that other ague which could only be cured by some other remedy. And so all agues, each of which requires a different medicine for its cure, must be agues absolutely dissimilar to one another.

Again, when two agues betray their difference, not only by symptoms palpably different from one another, but also , as I have said, by this, that the one can only be cured by one remedy and the other by another remedy, it plainly follows from this, that these two remedies must differ from one another in their nature and action, (Otherwise theone medicine must have been able to cure just as well that ague which yielded to the other medicine, if the action of both was the same.) and cannot be identical, consequently cannot be considered as the same thing, and therefore cannot reasonably be substituted for one another; in other words, the one ought not to be represented as a surrogate for the other.

Or have those gentlemen, who do not see this, some mode of thinking peculiar to themselves and unknown to me, some logic of their own that stands in direct contradiction to that of the rest of mankind?

Infinite nature in much more multiform in her dynamic endowment of medicinal substances than the compilers of medicinal virtues, called teachers of Materia Medica, have any idea of, and immeasurably more multiformin the production of innumerable deviations in human health (diseases) than the bungling pathologist enamoured of his natty classification is aware of, who, by his couple of dozen, not even correctly (What physician, except HIPPOCRATES, have ever described the pure course of any disease where no medicine has been given from the beginning to the end? Consequently, do not the recorded histories of diseases contain the symptoms of the diseases mixed up with those of the domestic remedies and drugs given during their course? ) designated, forms of disease, seems only to give expression to the wish that dear nature might be so good as to limit the host of diseases to a small number, so that his brother therapeutist and practitioner – his head stuffed full of traditional prescriptions – may the more easily deal with the little collection.

That the ordinary physicians, by mingling iron in the same prescription with bark, often dish up for the patient a repulsive-looking and unsavoury ink, may be overlooked, but they must be told that a compound results from this mixture that possesses neither the virtues of cinchona bark nor those of iron.

The truth of this assertion is manifest from the fact when cinchona bark has done harm iron is often its antidote and the remedy for its injurious action, as cinchona bark is for iron, when indicated by the symptoms caused by the unsuitable medicine.

Still iron can only remove some of the untoward symptoms, those, namely, which it can produce in similarity in healthy persons.

After long-continued treatments with large doses of china many symptoms often remain for which other medicines are required; for we frequently meet with china-cachexia of such a severe character that is only with great difficulty that the patient can be freed from them and rescued from dearth. In those cases, Ipecacuanha in small doses, more frequently Arnica, and in some few Belladona, is of use, the indication for the antidote being determined by the symptoms of the china-disease. Veratrum is useful when coldness of the body and cold sweats have been caused by bark, if the other symptoms of this drug correspond homoeopathically.

[HAHNEMAN was assisted in this proving by ANTON, BAEHR, BECHER, CLAUSS, FRANZ, GROSS, HARNISCH, HARTMANN, HARTUNG, HERRMANN, HORNBURG, CH. LEHMANN, J. G. LEHMANN, MICHLER, MEYER, STAPF, TEUTHORN, WAGNER, WALTHER, WISLICENUS.

The following old-school authoritues are quoted:

ALPINI, Hist, Febr. epid.

BALGIVI, Praxis, Lib. ii.

BAKER, in Medical Transactions, vol. iii. Lond., 1785.

BAUER, J. Fr., in Acta Nat. Cur., iii.

BERGER, JOH. GOTTFR., Diss. de Chinchina ab uniquis judiciis vindicata. Viteb., 1711.

BRESLAUER Samml., 1728.

CARTHEUSER, J. F., Diss. de Febre intermitt. Epid. Francoff ad V., 1749.

CLEGORN, Diseases of Minorca.

CRUGER, DAN., in Misc. Nat. Cur., Dec. iii, ann. 3.

ETTMULLER, B, M., Diss. de usu et abusu praecepit.

FISCHER,C. E., in Hufel. Journal f. pr. A., iv.

FORMEY, Med. Ephem., i, 2.

FOTHERGILL, Essays, tom. ii.

FRIBORG, Diss. de usu cort. Peruv., 1773.

GESNER, J. A. PH., Sammlung, v. Beob.,i. Nordlingen, 1789.

GREDING, in Ludw. Advers., tom. i.

HILDENBRAND, J,V. VON, in Hufel. Journ., xiii.

JUNCKER et FRITZE, Diss. de usu cort. Peruv. Discreto. Halae, 1756.

KOKER, JOH, DE (work not given).

KREYSIG, Diss. Obs. de Febr. Quart. Viteb., 1797.

LIMPRECHT, J.A., in Acta Nat. Cur., ii.

MAY , W., in Lond. Med. Journ., 1788.

MORTON, Opera, ii.

MURRAY, Apparat. Medicam, 2^nd edit., i.

PELARGUS, Obs., ii.

PELARGUS, Obs., ii.

PERCIVAL, Essays. vol. i.

QUARIN, Method. Med. Febr.

RAULIN, J., Observat. De Med. Paris, 1754.

RICHARD, Recueil d’ Observ. De Med., ii.

ROMBERG, j. W., Misc. Nat. Cur., Dec. iii, Ann. 9, 10.

ROSCHIN, in Annalen der Heilkunde, 1811, Feb.

SCHLEGEL, in Hufel. Journ., vii.

STAHL, J. E., Diss. Problem. De Febrobus, - Obs. Clin.

SYDENHAM, Opusc. Lips., 1695.

THOMPSON, AL., in Med. Inqu. And Observ., iv, No. 24.

THOMSON, THOM., Med. Rathpfleg. Leipzig, 1779.

In the Frag. De Vir. China has 221 symptoms, in the 1^st Edit. 1082, and in this 2^nd Edit. 1143.]

CHINA

Vertigo. [J. F. CARTHEUSER, (Results of suppression of intemittents by china) Diss. de Febre intermitt, epid. Francof. Ad. V., 1749.]

First vertigo and giddy nausea, then general feeling of heat. (Comp. with 1, 3, 4, 5.)

Vertigo in the occiput, when sitting. [Fz.]

Vertigo; the head tends to sink backwards, worse when moving and walking, diminished by lying down (aft. a few m.). [Hrr.]

5. Constant vertigo, the head tends to sink backwards, in every position, but worse when walking and moving the head (aft. 6 h.). [Hrr.]

Stupidity. [CARTHEUSER, l. c.]

He is long in collecting his thoughts, is much disinclined for movement, and more disposed to sit and to lie.

Confusion of the head. [C. E. Fischer, (Effects of china in agues.) in Hufel Journal, iv, pp. 652, 653. 657.]

Confusion of the head, like vertigo from dancing and as in catarrh. (Comp. with 11 and 49.)

10. Confusion and emptiness in the head and laziness of the body as from watching at night and sleeplessness. (10, 15, 21, comp. with 6, 8, 11, 12, 13, 14, 16 and 23.) (aft. 1 h.).

Confusion of the head, like a catarrh. § (aft. 9 d.). [Ws.]

Confusion of the head in the forehead. [Hbg.]

Confusion of the head, as after a debauch, with aching in the temples. [Hbg.]

A cloudiness spread all over the head, for half an hour. (aft. ¾ h.). [Htg.]

15. Stupefaction of the head, with aching in the forehead (aft. ¼ h.).

A dull feeling in the lower part of the head behind, as from awaking from sleep. [Bch.]

Heaviness of the head (at noon vertigo rises up into the head, without pain). (17, 20, comp. with 6, 8, 11, 12, 13, `4, 16 and 23.)

Heaviness of the head (18, 19, 22, see 17, 20) [J. E. STAHL. (As) in various works, particularly in his Diss. Problem. De febribus.]

Heaviness in the head, which tends to sink backwards, when sitting. [Hrr.]

20. Headache, like heaviness and heat in it, worst when turning the eyes, at the same time with twitching pains in the temples.

In the morning, on awaking from sleep, dull, stupefying headache.

In the morning, on awaking from sleep, heaviness of the head and weariness in all the limbs. [Lhm.]

In the morning, quite dazed in the head, as after a debauch, with dryness in the mouth. [Fz.]

Headache in the frontal region. [Fz.- Css.]

25. Aching shooting pain in the forehead and temple of one side (aft. 4 h.).

Headache in the temples. [Hbg.]

Headache, exhaustion, then some coldness. [Fz.]

Aching pain in the occiput. (28, 29, 30, 31, 33, 34, 36, see 35 and 39.) (aft. 3 h.). [Myr.]

Pressure on the left temple. [Hrr.]

30. Compression in the temples (aft. 5 h.). [Fz.]

In the evening, aching pain in the temple. [Fz.]

Headache from afternoon till evening, an aching in the middle of the forehead.

Aching pain in the right side of the forehead. [Gss.]

Aching pain in the forehead; on bending backwards it came with increased intensity in both temples; when sitting it remained confined to the forehead. [Bch.]

35. Aching pain when walking, first over the forehead, then in the temples. (Comp. with 28, 29, 30, 31, 33, 34, 26, 39.) (aft. 6 h.).

Headache, first an aching in the forehead, which then spreads all over the head. [Bch.]

Headache as if the brain was compressed from both sides and pressed out at the forehead, very much increased by walking in the open air.

Violent aching pains deep in the brain, and like constriction, especially in the right side of the forehead and in the occiput, very much increased by walking. (See 37, 40 – 46, 48, 50, 51, 53- 63, 65-67, 69, 70.) [An.]

Aching pain, especially in the occiput. [An.]

40. Aching, pressing headache, which is aggravated by open air (aft. 9 h.). [Htn.]

Hard pressure in the occiput, as if the cerebellum were pressed out (aft. 5.1/2 h.). [Myr.]

Painful aching and pressing in the head, towards the forehead, as if all were too heavy and would be pressed out, relieved by pressing strongly on it with the hand (aft. 8 h.). [Htn.]

Aching pressing headache in the side towards which he leans. [Htn.]

A kind of aching, as if oppressed ithe head, with frontal sweat (aft. ½ h.). [Wr.]

45. An aching, like fulness, in the head just over the eyes(aft. 2 h.). [Wr.]

The brain feels as if pressed by excess of blood. (37, 46, comp. with 38 and 40-45, 48 and 70.)

Headache over the orbits, which comes on in the forenoon hours, is increased by walking, but is removed by the mid-day meal (aft. 18 h.).

Headache as if the brain were kneaded together, with too great excitement of the mind, restlessness, inordinate and too rapid attentiveness and over-strainedness of the imagination. [Fz.]

Headache in the temples like stuffed coryza. (Comp. with 9 and 11.).

50. Pressive tearing in the temporal region as if it would press out the bone. (Tearing (drawing) pressure, and pressive tearing (drawing), seems to be a chief character of pain with china, see also, 686, 687, 739, 746, 779, 780.) [Hrr.]

Tearing pain in the left temple. [Lr.]

Headache now in one part then in another part of the brain.

Tearing on several spots in the head, aggravated by walking and by moving the head. [Hrr.]

Tearing headache from the right occiputal bone to the right frontal protuberance. [Hrr.]

55.Drawing headache from the occiput to the forehead, as if the whole forehead were contracted, which ended in the temples like a beating; it was alleviated by walking, increased by sitting and standing, and ceased by pressing on it with the hand. [Trn.]

Drawing headache in the occiput, when sitting. [Fz.]

Drawing pain in the head behind the ears to the mastoid process. [Htg.]

Drawing pain in the left side of the occiput; that goes off on bending back the head. [Fz.]

Drawing pain in the forehead. [Hbg.]

60. When he places his hand on his forehead there occurs there a to-and-fro drawing pain. [Fz.]

Violent twitching tearing on several spots in the head, which is increased by movement and by walking, diminished when lying (aft. 1 h.). [Hrr.]

Twitching tearing on the frontal protuberances. [Gss.]

Twitching tearing in the right temporal region, for three days. [Hrr.]

Twitching headache in the temple to the upper jaw. (Comp. with 65, 66, also partlywith 61, 62, 63.)

65. Twitching from both parietal bones of the head along the neck. (63, 65, see 64.). [Hbg.]

Headache, like a twitching towards the forehead, increasing in severity till evening, when it went off. [Ln.]

Digging headache in the left side of the forehead, when he sits doing nothing, or occupies himself with something for which he has no inclination. [Gss.]

Headache, first spasmodic in the vertex, then on the side of the head as if bruised, increased by the slightest movement.

Headache, a digging in the left side of the head, when sitting (aft. 9.1/4 h.). [Htn.]

70. Headache so painful, as if the skull would burst asunder; the brain beats in an undulating manner against the skull. [Trn.]

Violent hammering in the head towards the temples. [Ln.]

Headache in the left parietal bone, like beating. [Hbg.]

An uninterrupted, dull, cutting pain from both temples and occiput up into the orbits, more acute and severe when moving and when stooping. [Lhm.]

Shooting headache, especially in the left frontal region (aft. 1.1/2 h.). [Htg.]

75. Shooting betwixt forehead and temple on the left side; on touching the temple he felt a strong throbbing of the artery, and the shooting went off by this touching. (Comp. especially with 80, also with 74, 76, 77, 78.)

Betwixt forehead and vertex burning, severe stitches. [Htg.]

Continued shooting sensation in the right temple. [Wth.]

Shooting headache in the forehead (when sitting). [Lr.]

Fine shooting in the temple. [Fz.]

80. Shooting headache between the right temple and forehead, with strong pulsation of the temporal artery. (See 76.) (aft. ½ h.). [An.]

Single stitches, which darted from the internal ear upwards through the brain. [Trn.]

Shooting tearing on several parts in the head, increased by moving the head. [Hrr.]

Headache when walking in the wind, compounded of bruised and sore pain.

Headache, as if the brain were sore, which is increased by the slightest touching of the head or any part of it, but especially by strained attention and profound reflection, indeed, even by speaking.

85. The integuments of the whole head are so sensitive to touch that all thereon is painful, and the roots of the hair in especial seem to suffer (aft. 36 h.). [Gss.]

Painful drawing on the right side of the occiput. [Fz.]

Drawing pain in the occiput joint when touched, so that he must bend the head backwards. [Fz.]

Painful drawing in the occiputal bone. [Fz.]

Contractive pain on the left side of the occiput in the skin. [Gss.]

90. Contractive, external pain on the left side of the occiput; it feels as if the skin were drawn together on one point; not increased by touching. [Hrr.]

Pain as if the skin on the upper part of the head was grasped by a whole hand. [Gss.]

A pain drawing together in a circle on the middle of the head superiorly (aft. ½ h.). [Hrr.]

Sweat among the hair of the head.

Profuse sweat among the hair of the head.

Profuse sweat among the hair of the head when walking in the open air.

95. Sharp stitches on the left side of the hairy scalp. [Fz.]

Shooting itching in the hairy scalp (aft. 1 h.). [Fz.]

(A crawling in the skin of the forehead.)

Shooting aching externally on the left frontal protuberance, accompanied by vertigo and some nausea in the throat. [Hrr.]

Shooting aching on the right from protuberance, more violent when touched (aft. 10 m.). [Hrr.]

100. Frequent alteration of the colour of the face.

Paleness of the face. (101 to 104, comp. with 105.)

Bad, earthy complexion.

Pinched, pale face.

Hippoctratic face (pointed nose, hollow eyes with blue rings), indifference, insensibility ; he wants to know nothing about those around him, nothing about things that he most liked (aft. 1 h.).

105. Pinched sharpened features, pale, unhealthy-looking complexion, as after debauches. (See 101 to 104.) (Stf.)

Redness of the cheeks and of the ear-lobes.

Puffy, red face. [FISCHER, l. c.]

Heat of the face. [J. RAULIN. (Not accessible.) Observed. De Med, Paris, 1754, pp. 243, 248.]

On coming from the open air into the not warm room, there occurred burning heat in the face, [Stf.]

110. Alternate heat and redness in the face. [STAHL, l. c.]

Momentary contraction of the skin of the forehead, as if the skin in the middle of the forehead were drawn together on one point (aft. ½ h.). [Ws.]

Burning pain on the forehead and hot frontal perspiration. [Lhm.]

Aching over the face, especially near the nose and cheeks, together with a contraction of the eyelids, as if the upper and lower lids were drawn towards one another (aft. 3 h.). [Ws.]

Shooting pressure on the forehead, above the nose and on the cheeks (aft. 32 h.). [Fz.]

115. A pecking pain in the zygomatic process and in a right molar tooth. [Htg.]

Fine stitches in the right malar bone, which go off by pressure. [Htn.]

A boil on the cheek.

Soft pressure going upwards over the root of the nose and on the eye-brow, which goes off on touching, with tension of the skin of the left al nasi. [Fz.]

Aching in both eye-brows, more externally, aggravated by moving the frontal muscles (aft. 3 h.). [Myr.]

120. Pain above the left orbit.

Tearing on the outer canthus of the left eye. [Lr.]

Fine itching pain above the orbits. [Hbg.]

Itching on the left eye-lid. [Fz.]

A tickling sensation on the eye-lids (aft. 5 h.). [Htg.]

125. Violent pain in the eye-lids.

Dry feeling betwixt the eye-lids and eye-ball, causing rubbing pain on moving the eyelids, without alteration in the appearance of the eye. [Htg.]

Eye gum in the outer canthus (after sleep.).

Aching pain in the outer canthi. [Fz.]

Smarting first in one, then in other eye, accompanied by watering of them.

130. Aching smarting pain in the eyes as from salt, she must always rub them. (From the exhalation, compare with 137.) (aft. ½ h.).

Painless pressure in the eyes, such as is apt to occur from fatigue and want of sleep (aft. ½ h.).

Painless pressure in the eyes, such as is apt to occur from fatigue and want of sleep (Aft. 10.1/2, 12 h.). [Htn.]

On awaking, at night, the righteye felt as if it were swimming in water (aft. 19 h.). [Stf.]

In the eyes a sensation, as in general weakness, as if they were much sunk, which they are not (aft. ¼ h.). [Fz.]

A quivering, winking, trembling in both eyes (aft. 2.1/4 h.). [Lhn.]

135. Twitching to and fro to the left lower eye-lid (aft. 6 h.). [Ws.]

Lachrymation of the eyes, with creeping pains in them on the inner surface of the eye-lids. [Bch.]

The eyes are somewhat red, with aching burning pain in them, and much heat (in the afternoon) (aft. 6 h.). [Stf.]

Contracted pupils.

Contracted pupils (immediately and aft. 3.1/2 h.). [Bch.]

140. Contracted pupils (aft. 1 h.). [Stf.]

Pupils mobile, but more disposed to contraction than dilation (aft. 20 h.).

Dilated pupils (aft. 1.1/2h.). [Htn.]

Very dilated pupils 9aft. ¼ h.). [Htn.]

145. Extreme dilatation and almost immobility of pupils, with weakness of vision, so that he cannot see distant things distinctly (myopa), with high complexion and liveliness (aft. g h.). [Fz.]

Black points fly before the sight. (Comp. with 147-149.) (aft. 4 h.).

Darkness before the eyes. (147 – 149, see 146) [Lhm.]

Dimness of vision. [CARTHEUSER, l. c.]

Amauriosis. [Breslauer Samml., (Results of suppression of intemittents by china.) 1728. p. 1066.]

150. A ticking noise in the ear, as from a distant watch.

First a beating sensation in the ear, then a loud ringing. (151. 152, comp. with 153-155.)

Ringing in the ears.

Frequent ringing in the right ear, an at the same time a tickling crawling in it, as if an insect had crept in. (153 – 155, comp. with 151, 152.) [Bch.]

Ringing in the ears with headache in the temples. [Fz.]

155. Ringing in the ears with headache in the temples. [Lr.]

Roaring in the ears. (Comp. with 157.)

Roaring in the ears. (Comp. with 156.) [Css.]

Something seems to come before the hearing internally (as from deafness) (Comp. with 159.) (aft. 1 h.).

Hardness of hearing. (See 158.) [MORTON, (Observed effects of overdosing.) Opera, ii, pp. 76. 81.]

160. Tearing in the lobes of the ears. (Comp. with 165.)

Heat if the external ear.

A tickling in the ear. [Hbg.]

Vesicles behind the ears.

Eruption in the concha.

165. Tearing on the cartilage of the ear and in the external meatus auditorious. (See 160.) [Hrr.]

(Aching pain in the internal ear, like ear-ache) (aft. 3 h.).

Pain in the left ear only when touched (aft. 6 d.). [Ws.]

Aching pain in the root of the nose (after the heat of the cheek has gone) that spreads on to the side of the nose (aft. 5 h.).

Tearing pain on the back of the nose.

170. Smarting deep in the left nostril, every inspiration causing a sudden stitch-like pain; on compressing the nose the smarting becomes worse, and then it also itches externally on the back of the nose, in the evening (aft. ½ h.). [Fz.]

Fine needle-pricks on the cartilage of the septum narium. [Hrr.]

Redness and heat only on the nose (aft. 12 h.).

(He fancies he smells a corpse-like odour.)

Epistaxis, in the morning between 6 and 7 o’clock, after rising from bed, for several successive days. [Htg.]

175. Frequent profuse epistaxis. [RAULIN, l. c.]

Epistaxis after blowing the nose strongly. [Ws.]

On the upper lip, on the right side near the commissure of the mouth, sore feeling as after much wiping in coryza. (177, 178, see 179.) [Fz.]

On the lower lip, near left commissure of the mouth, pain as if an eroding ulcer were there. [Fz.]

The inner surface of the lower lip pains as if sore and excoriated. (Comp. wit 177, 178.)

180. Eruption on the lips and tongue; small ulcers which itch and burn much. [SCHLEGEL, (Effects of china on agues. This eruption is said to be critical.) Hufel, Journ. vii, iv. P. 161.]

(Puckered, wrinkled epidermis of the lips) (aft.5 h.)

The lower lip cracks in the middle (on sneezing).

(Chapped lips.)

Dry lips, without thirst (aft. 7 h.). [Fz.]

185. Blackish lips. [DAN, CRUGER, (Results of suppression of intemittents by china) in Misc. Nat. Cur., Dec. iii, Ann. 3.]

Speechlessness. [RICHARD, (Results of suppression of intermittents by china) Recueil d’Observ. De Med., ii, p. 517.]

Slight rigor, followed by speechlessness. [A. THOMPSON, (Results of suppression of intemittents by china. This symptom, with S. 448, 574, 602, 676, 698, occurred in a hysterical subject instead of a paroxysms of ague.) in Med. Inq. And Observ. iv, No. 24.]

At night (before 12 o’clock) tearing pressure in the right upper and lower jaw. (Comp. with 199, 203, 204, partly also with 191, 198, 200, 202, 206.)

On the upper jaw a cutting, burning pain (when standing) (aft. 7 h.). [Fz.]

190. Twitching, obtuse stitches in the right lower jaw. (See 195, 207.) [Wth.]

Tearing on the left lower jaw. [Hrr.]

Swelling of the gums and lips. [FORMEY, (Not accessible) Med. Ephem., I, 2.]

Drawing toothache readily occurs in the open air and when exposed to a draught of air.

Toothache; stuffed coryza and watering eyes.

195. Toothache, a shooting outwards in the front teeth. (Comp. with 190 and 207.)

Toothache with looseness of the teeth (aft. 3 h.).

Loose teeth only painful when chewing.

On biting the teeth together aching pain in the crowns of the right molars. [Fz.]

Toothache, like an aching drawing in the left lower jaw. (See 188, 203, 204.) [Fz.]

200. Twitching tearing in the upper back molars of the left side (aft. 5 h.). [Htn.]

Digging in the upper molars, diminished momentarily by biting the teeth together and pressing on them (aft. 40 h.). [Htn.]

(During the accustomed tobacco-smoking) tearing toothache extending upwards and backwards in the upper jaw followed by a sort of fainting fit. [Fz.]

Aching, drawing pain in the left upper row of molars, with sensation as if the gums or the inside of the cheek were swollen (aft. 1 h.). [Fz.]

In the morning, drawing, aching toothache in one upper molar, with sensation of numbness in it (aft. 24 h.). [Fz.]

205. The lower incisors are painful, as if they had been knocked.

In the morning, drawing pain in the incisor teeth. (For 204 and 206 Rhus toxicodendron seems to be an antidote.).[Fz.]

Small, fine stitches, with tearing in the right upper molars, neither diminished nor increased by touching or drawing in cold air. (See 190, 495)(aft. 2.1/2 h.). [Htn.]

Throbbing toothache. (Comp. with 209.)

Pecking pain in one of the upper molars. (See 208.) [Htg.]

210. Sore-throat. (In original “angina faucium.)

In the pit of the throat, sensation as if it would be painful on swallowing, like a sore-throat (and yet it does not hurt when he swallows).

Painful deglutition, swollen submaxillary glands, which are painful, especially when he swallows.

A shooting on the right side in the throat only when he swallows.

Throat internally as if swollen; shooting pain on the left side of the tongue only when swallowing; there is only aching pain at this spot when speaking and breathing.

215. In the evening, after lying down, shooting in the throat, not when swallowing, but when breathing.

Contractive sensation in the throat. (217, 219, see 224, 225.)

(A choking and contraction in the gullet without impediment to breathing.)

Deglutition difficult, as if caused by narrowing of the throat. [An.]

220. On bending back the head, tension in the gullet, which, however, does not prevent deglutition. [Fz.]

Scratching on the palate, also when not swallowing (aft. 8 d.). [Ws.]

Tobacco-smoke seems to him unusually acrid and stinging at the back of the palate (aft. 24 h.). [Fz.]

Tiresome rough feeling in the throat. [Stf.]

Painless swelling of the velum palati and uvula (224, 225, comp. 217, 219.) (aft. 3 h.).

225. Painful swelling on the side of the tongue posteriorly.

It smarts on the middle of the tongue as if the part was excoriated or burnt.

A vesicle under the tongue, which is painful when the tongue is moved.

Fine stitches in the tip of the tongue. (Comp. 231.)

Sensation on the tongue as if it were dry and covered with mucus. (Comp. 239 to 241.). (aft. 1 h.).

230. Smarting on the tip of the tongue as from pepper, then accumulation of saliva at this part. [Fz.]

Burning stitches on the tongue. (See 228.). [Hrr.]

Here and there in the parotid gland flying shopains.

Simply painful submaxillary glands (under the angle of the lower jaw), especially on touching and on moving the neck.

A choking or squeezing aching in one of the right submaxillary glands per se , but more when moving the neck or touching it.

235. Contractive sensation in the salivary glands; ptyalism. [Fz.]

Much saliva in the mouth with nausea (aft. 2 h.). [Ln.]

Collection of saliva, combined with nausea.[Hbg.]

After an agreeable surprise much bright blood came rapidly into the mouth (aft. 24 h.). [Stf.]

Dryness in the mouth. (239 to 211, see 229.). [STAHL, Obs. Clin., pp. 144, 171.]

240. Dryness in the mouth with thirst. [Hbg.]

Great feeling of dryness in the throat, with cool breath (aft. 1 h.). [Ln.]

(Yellowish tongue, not covered with dirty fur).

Thickly furred tongue, especially in the afternoon, especially in the afternoon (aft. 7 h.). [Htg.]

In the morning very white furred tongue.

245. Tongue covered with a thick, dirty white crust (aft. ¼ h.). [Gss.]

Yellow furred tongue. [FISCHER, l. c. – Bch.]

Yellowish furred tongue. [Bch.]

Clean tongue, with bitter taste. [SCHLEGEL, l. c.]

The mouth is slimy, and the taste watery and insipid.

250. Slimy taste in the mouth, which makes butter nauseous.

After drinking, flat, qualmish taste in the mouth.

Bitter taste of food, especially of flour-cakes (252, 258, 262, comp. with 261, partly also with 258, 263, 266.) (aft. 6 h.).

Though he has no bitter taste per se in the mouth, yet all he eats tastes bitter; after swallowing the food there was no longer bitterness in the mouth.

Constant bitter taste in the mouth. (254, 255, comp. with 256 to 260.)

255. In the morning, bitter taste in the mouth.

Bitter taste (256 to 260, see 254, 255.) [FISCHER, l. c.]

Bitterness of the mouth. [QUARIN, (Physical effects of powder.) Method Med. Feb., p. 23.]

Bitter taste in the mouth; tobacco tastes bitter when smoking. [Fz.]

Bitter taste in the throat, causing him to swallow his saliva constantly (immediately) [Htn.]

260. A nasty, sometimes bitter taste in the mouth, especially in the morning; the food did not taste nice, but not bitter. [Hrr.]

Bitter taste in the mouth on drinking coffee. [Css.]

Beer tastes in the mouth on drinking coffee. [Css.]

Beer tastes bitter and goes to his head.

Bread when chewed tastes well, but is bitter when swallowed. [Fz.]

Bitter salt taste of roll and butter, with dryness in the palate and thirst; when not eating there is no abnormal taste in the mouth, only dryness and thirst. [Bch.]

265. Salt taste in the mouth. (Comp. with 660, partly also with 264 and 271.)

All food tasted uncommonly salt, afterwards bitter. [Myr.]

Sourness in the mouth. (See 268, 272, 275.) [Fz.]

Frequently a sour taste in the mouth as if his stomach was deranged by fruit.

Black bread tastes sour. (269, 270, comp. with 316, partly also with 315.) (aft. 3 h.).

270. Coffee tastes sourish.

A sweetish then sour taste in the mouth, much saliva. [Fz.]

Sweetish taste in the mouth. [Wth.]

Tobacco when smoked tastes sweetish. [Wth.]

275. A sensation in the mouth causing collection of saliva, as if he had smelt strong vinegar. (268, 275, comp. with 267, 272.)

Nasty taste in the mouth as after cheese. [Hsch.]

Sensation as of a putrid exhalation out of the mouth.

Towards morning a nauseous, putrid smell out of the mouth, which goes off as soon as she eats something.

Mucus in the mouth in the morning after walking and after some prolonged exertion, which he thinks must smell ill to those about him; he thinks he smells badly out of the throat.

280. He has no taste when he smokes. (See 282.) [An.]

He cannot bear his (accustomed) tobacco smoking, it affects his nerves. (Comp. with 281, partly also with 274, 280.)

He feels always as if he had eaten, drunk, and smoked to satiety, and yet he has a proper, good taste of all those things. (283, 290, comp. with 297.) (aft. some hours.)

Aversion from coffee, though food tastes right.

285. Aversion from beer.

Aversion from water and inclination for beer.

Great longing for wine.

Supper has little taste. (See 256.) [Hbg.]

Supper is relished, but he is immediately satiated, and hence can eat but little.

290. No desire for food, but little taste is all right.

Anorexia. [J. W. ROMBERG, (Effects of china in agues.) Mis. Nat. Cur., Dec. iii, Ann. 9, 10, Obs. 109.]

Little appetite. [Hrr.]

Indifference to food and drink; it is only when he begins to eat that some appetite and relish for food comes. (aft. 6 h.).

No desire for food or drink. (Comp. partly with 299, 300.)

295. Want of appetite as from slight nausea. (See 298.) [Htg.]

The midday meal is not at all relished. (Comp. with 288, partly also with 210.)

Little appetite at noon from feeling of satiety. (See 285, 290.) [Bch.]

Extreme aversion from and loathing of not disagreeable food, even when it is not present and he only hears it mentioned, with dread of work, constant day-drowsiness, and yellowness of the eye-balls (Comp. with 295.) (aft. 8 h.).

Little thirst. (See 294.) [An.]

300. No thirst when eating. [Bch.]

Canine hunger, with insipid taste in the mouth.

She is hungry, but does not relish her food.

Hunger and yet want of appetite; the food which tasted right was disagreeable to him in his mouth. [An.]

Hunger at an unusual time in the afternoon. [Htn.]

305. Longing appetite; he has longings, but he knows not for what. (305, 306, 307, comp. with 308.)

He has appetite for many things, but knows not rightly for what.

Longing often for unknown things.

In the morning (8 o’clock) great hunger and appetite, he knows not for what. (See 305, 306, 307.) [Lhm.]

Great desire for sour cherries. [Bch.]

310. A kind of ravenous hunger, with nausea and inclination to vomit (aft. 2 h.).

Feeling of emptiness in the fauces and oesophagus ( aft.11 h.). [Ws.]

First a burning , then an agreeable warming sensation from the upper part of the chest to the stomach. [Htg.]

Scraping sensation in the fauces, especially on the border of the larynx, as after rancid eructation or heart-burn.

Eructation (314, 317, see 321) (immediately). [Htn.]

315. After bread and butter bitter, sourish eructation . (See 319.) [Lhm.]

After partaking of milk incomplete, sourish eructation. (See 269, 270.) (aft. 1.1/2 h.). [Fz.]

Tasteless eructation after eating. [Stf.]

A nasty slime often rises up.

After a meal bitter erucation. (Comp. with 134, 317.) (aft. 2 h.).

320. Eructation with the taste of the food he had eaten.

Empty eructation of nothing but air (Comp. with 314, 317.) (aft. 2 h.).

A sighing king of movement with eructation, intermediate between sighing and eructation (aft. ¾ h.).

Eructation, as if caused by loathing, and pain in the abdomen (aft. ¾ h.). [Wr.]

An eructation, as from inclination to vomit (aft. 1 h.). [Wr.]

325. Whilst eating and drinking shooting in the side and back, and constant inclination to vomit (aft. 5 h.).

Whilst eating drawing twitching pain in the side of the abdomen (aft. 2 h.).

After a meal, nausea in the region of the pit of the throat. [Hrr.]

Want of appetite and nausea, he has always an inclination to vomit without being able to do so ( forenoon and afternoon).

After eating fulness, and yet good appetite before the meal (329, 330, 339, comp. with 338.).

330. After eating, distension of the abdomen, like fulness.

After eating, distension of the abdomen, like fulness.

After eating a motion of the bowels.

After eating drowsiness. (332, 333, 334, comp. with 347, 348.)

After the midday meal great desire to lie down and sleep.

After eating exhaustion, so that he would like to lie down and sleep.

335. After eating the loathing, the flying heat and ebullition of blood go off.

Nausea [BAKER, (Effects of Cinchona rubra. This symptom on both from the powder.) Med. Transact. Iii, p. 162. – QUARIN, l. c.]

Nausea with good appetite. [SCHLEGEL, l. c., p. 161.]

He feels as if some remained up in his throat (aft. 3 h.0. [Stf.]

After a meal he remains for a long time as full as when he had just eaten; the food seems to stick high up.

340. Inclination to vomit. [Mch.]

Nausea without vomiting. [Lhm.]

Inclination to vomand vomiting.

Vomiting. [MORTON, l. c. – BAKER, l. c. – FRIBORG, (Physical effects of the powder.) Diss. de usu cort. Peruv., 1773.]

Continued vomiting. [J. FR. BAUER, (Results of suppression of intemittents by china.) Acta Nat. Cur. iii, obs. 70.]

345. Half an hour after the midday meal pressing aching headache that lasted till bed-time. [Wr.]

After a moderate meal followed by walk, while sitting sick anxiety in the stomach, as from over-loading and derangement of the stomach, and yet at the same time hunger. (See 364, 366, 367, 368, 369.) [Fz.]

Weariness and laziness after dinner. (347, 348, see 332, 333.) [Htn.]

Exhaustion and drowsiness after supper (aft. 12 h.). [Htn.]

After a meal a hard pressing pain in both sides below the navel. (See 350.) [Bch.]

350. After a moderate supper, eaten with appetite, immediately colic, that is: distented abdomen and here and there sharp aching pains mixed with pinching in all the bowels. (Comp. with 349.)

Stomachache, spasm of stomach. (Comp. with 352 – 355 and 359, 360, 362, 363, 365.)

Pressure in the stomach. (352 to 355, see 351.) [ROSCHIN, (Not accessible.) Annalen der Heilkunde 1811, Febr.]

In the morning in bed, when lying on the side a pressure in the stomach (as if it were constricted), which went off on lying on the back. [Stf.]

In the stomach a pressure as from fullness. [Hbg.]

355. In the stomach violent aching, which went off while eating (Alternating action with 356.) [Stf.]

After eating any food, however little, immediately a hard long-continued pressure in the stomach. (See 357, 358.) [Hrr.]

After every meal hard pressure in the stomach. (357, 358, comp. with 356, and, on the other hand, the alternating action 355.) [Hrr.]

With a good appetite, after eating (vegetables), at first stomachache, then accumulation of flatulence, then vomiting.

Weight and pressure in the stomach. (359, 360, 362, 363, 365, see 351.) [PERCIVAL, Physical effects of powder) Essays, vol. i.]

360. Heavy pressure in the stomach. [KREYSIG, (Not accessible.) Diss. Obs. de Febr. Quart., Viteb., 1797, p. 17.]

After aching in the stomach, a burning rises half way up in the chest.

Oppresses the stomach. [BAKER, l. c.]

Feeling of fulness in the stomach. [An.]

The food partaken of at supper remains undigested in the stomach. (364, 366, 367, partly also 369, comp. with 346 and 368.)

365. Feeling of heaviness in the stomach. [QUARIN, l. c.]

Milk readily deranges the stomach.

By taking rather too much food, even of the most innocent kind, the stomach is immediately deranged, and an insipid taste in the mouth, a fulness in the abdomen, crossness and headache come on.

Indigestion. [FRIBORG, l. c.]

Feeling of emptiness and qualmishness in the stomach.

370. Feeling of coldness in the stomach.

After every mouthful of drink feeling of internal coldness in the epigastrium, which is renewed at every breath (aft. 4 h.).

Pain in the region of the stomach, like aching, which alleviated every time he rises from his seat, recurs on sitting down and lasts two hours (aft. ¾ h.). [Wr.]

Tearing aching under the last true ribs, at the left side of the ensiform cartilage. [Gss.]

Sore sensation with pressure (or pain as if a wound were pressed on) in the region of the scrobiculus cordis (several mornings). [Gss.]

375. A violent aching under the scrobiculus cordis, as if all were excoriated there, the same in all positions, also when touched; soon after this a violent diarrhoea, whereby the pain in the scrobiculus cordis was not relieved (aft. 7 h.). [Myr.]

Stomachache, which takes away the breath. [STAHL, l. c.]

A squeezing together in the scrobiculus cordis, which impedes inspiration (aft. ½ h.). [Htn.]

Sufferings under the short ribs. [STAHL, l. c.]

Hypochondrial sufferings. [STAHL, l. c.]

380. Anxiety in the region of the scrobiculus cordis. [CARTHEUSER, l. c.]

Pain in the abdomen, aching, pinching (shooting), under the scrobiculus cordis, as if diarrhoea would ensue, but no stool comes, in the evening. (382, 383, but especially 390 to 392, comp. with 386, 459.) (aft. 36 h.). [Fz.]

Twitching shooting in the stomach (aft. 3 h.0. [Wth.]

Under the last rib contractive pain and as if bruised, only when walking. (See 433, 455, also 446 to 453.) (aft. 24 h.). [Fz.]

Flying stitches here and there in the stomach and abdomen. (Comp. with 391, 398, 399, 402, 403, and 464 tp 469.)

After every drink a stitch in the precordial region. (Comp. with 638.)

After every mouthful of drink shivering or chillness with goose-skin (aft. 6 h.).

After drinking griping as from a purgative.

390. Sharp stitches in the scrobiculus cordis. (See 649.) [Hrr.]

Sharp stitches in front under the last ribs, without relation to expiration or inspiration. (See 386, 398, 399, 402, 403, and 464 to 469.) [Gss.]

Shooting pain in the scrobiculus cordis to the sternum. [Lhm.]