Cinchona Boliviana cinch-b.

A Dictionary of Practical Materia Medica

John Henry Clarke · A Dictionary of Practical Materia Medica · 1st edition (1900-02, three volumes); homeoint.org / Médi-T HTML digitization

General

Cinchona Boliviana (a variety of Cinchona calisaya growing further north). N. O. Rubiaceæ. Tincture of bark.

Clinical

Aphthæ. Corns. Coryza. Hands, red. Mouth, commissures ulcerated. Pneumonia. Wry-neck.

Characteristics

China Bol . was proved by Modiedo, and the proving is accepted by Hering. It presents the main features of Chi. off ., but some are peculiar and deserve separate mention. Among these are: Ulceration of commissures of mouth. Cough with dagger-like pains in base of right lung. Rigidity of nape of neck. Hands red; hot; or cold and sticky. There is also sticky sweat about anus. Flatulence, disturbed and dreamful sleep, and sensitiveness to touch are common to both.

Mind

Cowardice. ─ Gloom alternating with serenity. ─ Alternation of bad and good humour. ─ Fits of rage, blasphemes.

Head

Vertigo as after a drunken fit, voracious appetite. ─ Headache in morning on awaking; leaves during the day, or lasts all day and leaves during sleep.

Eyes

Violent pains like a stab in l. eye, followed by itching and tears.

Ears

Detonation as of a cannon in r. ear. ─ Ringing, humming, whistling sounds.

Nose

Much sneezing on awaking with smell of fresh pus. ─ Sensation of incipient cold with tight feeling and pain in throat. ─ Violent cold in head. ─ Mucus from posterior nares.

Face

Aphthæ on inner surface of lips; ulceration of commissures.

Mouth

Mouth bitter, morning on waking.

Throat

Constriction and burning in throat.

Appetite

Hunger, or lack of appetite; repugnance to meat. ─ After eating: weight in stomach; cold; sneezing; sleepy and desire to sleep in evening.

Stomach

Much gas rises from stomach.

Abdomen

Pain in both hypochondria and under ribs on waking in the morning. ─ Pain in splenic region.

Anus

Biting in anus as from worms; excoriated sensation. ─ Viscous sweat on anus.

Male Sexual Organs

Pollutions exceedingly weakening. ─ Excoriation on inner and lower part of prepuce. ─ Gleet and ulceration of prepuce.

Respiratory Organs

Cough with pain in r. lung, as from a dagger buried there; at times makes breathing laborious; burning in eyes; extremities cold. ─ Unbearable pain in r. lung, extends to region of liver, sensitive to touch.

Neck and Back

Nape of neck rigid, cannot turn head to r.; any sudden movement causes a snap or crack. ─ Wry-neck. ─ Pain in: l. shoulder; in l. buttock, and also in r. hip-bone on sitting up in bed.

Upper Limbs

Hands red; vessels distended. ─ Hands hot, even in cold and rainy weather. ─ Hands cold, sticky.

Lower Limbs

Legs and feet icy cold, as if blown on by wintry wind. ─ Painful corns.

Sleep

Dreams: of sea; of fishes; of swimming; of bathing; of journeys by land and sea; of vomiting worms.

The Guiding Symptoms of Our Materia Medica

Constantine Hering · The Guiding Symptoms of Our Materia Medica · 1879–91

General

A variety of Cinchona Calisaya, discovered by Weddell in Bolivia, growing somewhat further northward than Calisaya.
PROVER. --M. M. Modiedo, Bogota, La Homœopatia, vol. 1, p. 333.

Mind

Painful sense of humiliation.
Excessive gloominess with alternations of serenity ; hilarious in evening.
Great lack of moral courage ; disposed to feel cowardly.
Feels sad, like shedding tears ; thinks much about future.
Feels abandoned and deserted.
Fits of rage, breaks out in blasphemous and improper language.
Alternate bad and good humor.
Calm, feels repentant, resigned.
Absent-minded while conversing.

Sensorium

Vertigo as after a drunken fit, voracious appetite.
Head feels heavy, stupid.

Inner head

Dull headache in morning on awaking, leaves during day.
Violent headache on awaking in morning, continuing all day and night and following day, leaving during sleep on next night.
Headache after eating.
Pulsations in left side of head.
Headache with pulsations over right eye.
Head heavy and hot.

Outer head

Sweat on forehead.
Pain in roots of hair on crown of head.
Some of hair falls off in a spot where pain was felt.

Sight and eyes

Turning head to right, with eyes closed, seems to see a bright flame extending horizontally from r. to left, terminating in a point ; feels as if caused by pressure on lids.
Desires to close eyes at night during fever.
Burning pain in eyes, wants to rub them.
Veins in inner angle of left eye injected ; morning.
Cramplike pain in inner angle of right eye.
Violent pain like a stab in left eye, followed by itching and tears.
Lids weak, drooping.

Hearing and ears

Sudden sounds as of a far-off landslide, and detonation of a cannon, in right ear.
Sounds in left ear as of ringing of bells, at night.
Sounds like humming of bees in left ear, and as of blowing of a trumpet, at night.
Whistling sound in right ear, at night.
Deafness in left ear ; took large ball of cerumen from it.

Smell and nose

Much sneezing on awaking in morning, with smell as of fresh pus or semen when sneezing first begins in head.
Sensation as of incipient cold with tight feeling and pain in throat.
Violent cold in head ; coryza.
Nostrils dry, stopped up.
Mucus from posterior nares.

Upper face

Face : hot ; pale ; sweating ; cadaveric.
Pulsation in left side of face extending to ear.
Painful pustule on prominence of right cheek bone.

Lower face

Aphthæ on inner surface of lips.
Ulceration of commissures of mouth.
Slight eruption on lower lip, much itching ; pustules leave before fully forming.

Teeth and gums

Teeth on edge, sore on chewing, especially l. side.
Deep pulsation in decayed teeth, left side.
Gums feel excoriated at base of teeth, < left side.

Taste, speech, tongue

Taste : saltish ; acid ; as of iron ; insipid ; as of blood.
Tip of tongue feels as if burnt.
Epithelium peels off base of tongue.
Sensation on tongue as of violent bites, seemingly extending towards left, also to right.

Inner mouth

Mouth bitter ; morning on awaking.
Aphthæ.

Palate and throat

Feeling of constriction and burning in throat.
Tonsils painful.

Appetite, thirst. desires, aversions

Hunger, or lack of appetite ; repugnance to meat.
Thirst during day ; also in morning.

Eating and drinking

At night, after preserves, mouth suddenly fills with extremely sour liquid.
After food, feeling of weight in stomach.
After eating : cold ; sneezing ; sleepy, and desire to sleep early in evening.

Hiccough, belching, nausea and vomiting

Much gas arises from stomach.
Nausea while eating at night.

Scrobiculum and stomach

Heat in skin in region of stomach.
Unpleasant sensation in stomach on lying down.

Hypochondria

Pain in hepatic region.
Pains in both hypochondria and under short ribs on awaking in morning.
Pain in splenic region.

Abdomen and loins

Cramplike pain in lower part of abdomen, right side.
Great heat as from a poultice.
Pricking as from pins in pubis.

Stools and rectum

Hard, then soft stools, without diarrhœa.
Expulsion of gases from intestines.
Impulse to stool at night ; stools hard, scanty.
Biting in anus as from worms ; excoriated sensation.
Viscous sweat on anus.

Urinary organs

Pain in left kidney on sitting down on bed, in morning.
Heavy pressure in bladder ; cramp in sphincter ; tenesmus on urinating.
Flow of urine bifurcated ; or small stream curving to right.
Flow of urine frequent and clear.
Urine forms in nebulous flocks, smelling very strong in a few hours.

Male sexual organs

Morning erections, no sexual desire.
Pollutions exceedingly debilitating.
Pricking, crawling in urethra up to sphincter.
Excoriation on inner and lower part of prepuce.
Gleet and ulceration of prepuce.

Cough

Cough dry, then loose ; sputum saline or tasting of blood ; sputum of milk-white globules of mucus.
Dry cough with great pain in right lung as from a dagger buried there ; at times makes breathing laborious ; burning in eyes ; head very uncomfortable ; extremities cold. θ Pneumonia.

Inner chest and lungs

Pain in chest as if it was one great sore.
Unbearable pain in right lung, extends to region of liver ; sensitive to touch ; at times takes away breath ; with tenacious dry cough of a metallic ring.
Dull cramp in thoracic cavity.
Violent attack of pneumonia.

Heart, pulse and circulation

Palpitation ; heartache.
Pulse feeble and quick during nocturnal fever.

Neck and back

Nape of neck painfully rigid, cannot turn head to right ; any sudden movement of head causes a snap or crack.
Sudden violent cramp in anterior lower part of neck causing fright.
Pain in left buttock, also in right hip bone and left kidney on sitting upon bed in morning.
Wry neck.

Upper limbs

Rheumatic pains in left shoulder.
Rheumatic pains in left arm from shoulder to hand, also in both arms.
Dull pains alternate from arm to arm.
Pains in right arm on moving it.
Left arm and hand lose sensation of touch, followed by cramplike pain about left thumb-nail, which impedes movement in first joint of thumb, feels as though the nail was about to fall off, and is painful to touch, all day.
Rheumatic pains from left wrist to elbow.
Pains in joints of both hands.
Pricking pains in hands.
Lack of strength in arms and hands.
Hands red ; vessels distended.
Hands hot even in cold and rainy weather.
Hands cold, sticky.
Considerable and prolonged hemorrhage from a small wound on inner part of joint of first phalanx, second finger of right hand.

Lower limbs

Convulsive pains in muscles of left thigh.
Pricking pains in legs.
Pains in left knee.
Legs and feet icy cold as if blown on by a wintry wind.
Sudden, violent pulsating in joint of right big toe ; cramp in it at night, on lying down.
Rheumatic pains in right foot.
Painful corns which grow very rapidly on both feet.

Rest. position. motion

After lying down : no disposition to sleep.
On lying down : unpleasant sensation in stomach ; sudden violent pulsating in joint of right big toe ; sudden and profound sleep.
On sitting down : pain in left kidney.
On sitting up in bed : pain in left buttock, and in right hip bone.
Cannot turn head to right, nape rigid, any sudden movement causes a snap or crack.
Turning to right, eyes closed, seems to see a bright flame horizontally from right to left terminating in a point.
Pains in right arm on moving it.

Nerves

Feels exceedingly lazy in bed in morning, but cannot go to sleep again.
Inclination to oscillation of body after writing.
Nervous susceptibility, cannot bear noise.
Whole body uneasy.

Sleep

No disposition to sleep after lying down.
Sudden and profound sleep on lying down.
Dreams : of the sea ; of fishes seen swimming ; of persons bathing ; of journeys ; of journeys by water ; of mule driving ; of death and about dead persons ; of vulgar scenes ; of vomiting worms ; of disputes about money matters.
Drools from mouth in sleep.

Time

In morning : dull headache on awaking ; violent headache on awaking ; veins in inner angle of left eye injected ; much sneezing on awaking ; mouth bitter on awaking ; thirst ; pain in both hypochondria and under short ribs on awaking ; pain in left kidney on sitting down ; erections ; pain in left buttock and right hip bone on sitting up in bed ; in bed, feels lazy but cannot go to sleep again ; feels cold in bed.
Evening : hilarious ; desire to sleep ; fever.
At night : desire to close eyes during fever ; sounds in left ear as of a trumpet ; whistling in right ear ; mouth fills with a sour liquid after preserves ; nausea while eating ; impulse to stool ; fever ; sudden, violent pulsation in joints of right big toe ; cramp in right big toe ; feels cold in bed ; heat of body.

Temperature and weather

Disinclination for a bath.
In cold rainy weather : hands hot.

Fever

Feels cold in bed all night ; also in morning.
General excessive cold during day ; heat of body at night.
Fever, P. M., after dinner head heavy, burning in eyes, frequent sneezing ; cold feet.
Sweat excessive on face and head ; burning in eyes ; veins swollen ; pulse 96 to 104.
Intermittent fever.

Attacks, periodicity

Sudden : sounds in ears ; pulsating in joints of right big toe.
Frequent : flow of urine ; sneezing.
At times : laborious breathing.
During day : thirst ; general excessive cold.
All night : feet cold in bed.
Alternate : dull pains from arm to arm.
Intermittent fever.

Locality and direction

Right : headache, with pulsations over eye ; cramplike pain in inner angle of eye ; detonation of cannon in ear ; whistling in ear ; painful pustule on prominence of cheek bone ; cramplike pain in lower part of abdomen on side ; stream of urine curves ; pain in right hip bone ; rheumatic pains in arm ; sudden, violent pulsating on joints of big toe ; rheumatic pains in foot.
Left : pulsations in side of head ; veins in inner angle of eye injected ; violent pain like a stab followed by itching and tears in eye ; sounds like ringing of bells in ear ; sounds like humming of bees in ear, as of blowing of a trumpet ; deafness in ear ; pulsations in side of face, extending to ear ; soreness of teeth on chewing ; pulsating in decayed teeth on side ; gums feel excoriated ; pain in kidney ; rheumatic pains in shoulder ; pain in buttock ; rheumatic pains in arm, front shoulder to hand ; hand and arm lose sensation ; convulsive pain in muscles of thigh ; pains in knee.
From left to right : seems to see a bright flame terminating in a point ; toothache.
Right then left : crawling in ears.

Sensations

As of a stab in left eye ; as of a far-off landslide sounding in ears ; as of incipient cold ; as of teeth being on edge ; as if tip of tongue was burnt ; as of violent bites on tongue ; as of a dagger buried in right lung ; as if there was one great sore in chest ; as if legs were blown on by a wintry wind.
Pain : in roots of hair on crown of head ; in throat ; in tonsils ; in hepatic region ; in both hypochondria and under short ribs ; in splenic region ; in left kidney ; in right lung, with cough ; in chest ; in left buttock ; in right arm on moving it ; in joints of both hands ; in left knee ; in corns.
Unbearable pain in right lung, extending to region of liver.
Burning : in eyes ; in throat ; constriction in throat.
Excoriated feeling : of gums on left side ; in anus ; on inner and lower part of prepuce.
Biting : in anus, as from worms.
Pricking : in pubis, as from pins ; in urethra up to sphincter ; in hands ; in legs.
Convulsive pains : in muscles of left thigh.
Soreness : of teeth on chewing.
Dull pains : alternate from arm to arm ; in head.
Dull cramp : in thoracic cavity.
Sudden cramp : in anterior lower part of neck.
Cramplike pain : in inner angle of right eye ; in lower part of abdomen, right side.
Cramp : in sphincter ; about thumb-nail ; in right big toe.
Rheumatic pains : in left shoulder ; in left arm from shoulder to hand ; in both arms ; from left wrist to elbow ; in right foot.
Pulsations : in left side of head ; over right eye ; in left side of face, extending to ear ; in decayed teeth on left side ; sudden and violent in joint of right big toe.
Tight feeling : in throat.
Heavy pressure : in bladder.
Pressure : on lids.
Heaviness : of head.
Weight : in stomach.
Uneasiness : in whole body.
Crawling : in urethra up to sphincter.
Unpleasant sensation in stomach on lying down.
Itching : in left eye ; of eruption on lower lip.
Heat : in skin, in region of stomach ; in abdomen ; as from a poultice ; of body.
Coldness : after eating ; of hands ; of feet ; icy coldness of legs.
Dryness : of nostrils.
Hands sticky.

Touch. passive motion. injuries

Touch : unbearable ; pain in right lung, extending to region of liver, sensitive to.
Rubbing : wants to rub eyes.

The Therapeutics of Fevers

H. C. Allen · The Therapeutics of Fevers · 1902 Library of Congress printing (Allen d. 1909; public domain)

Characteristic

Adapted to stout, "swarthy" persons; to systems once robust which have become debilitated, "broken down," from exhausting discharges.

Apathetic, indifferent, taciturn (Phos. ac.); despondent, gloomy, has no desire to live, but lacks courage to commit suicide.

Ailments: from loss of vital fluids, especially hemor- rhages, excessive lactation, diarrhœa, suppuration (Chin. s.); of malarial origin, with marked periodicity; return every other day.

After climacteric with profuse hemorrhage; acute diseases often result in dropsy.

Pains: are darting or drawing-tearing; in every joint, all the bones, periosteum as if strained, sore all over; obliged to move limbs frequently as motion gives relief (Eup., Rhus); renewed by contact, and then gradually increase to a great height; < slightest touch, > by hard pressure.

Great debility, trembling, aversion to exercise; nervous; sensitive to touch, to pain, to drafts of air; unrefreshing sleep < after 3 A. M.

One hand icy cold, the other warm (Dig., Ipec., Puls.).

Headache: as if the skull would burst; intense throbbing of head and carotids, face flushed; from occiput over whole head; < sitting or lying, must stand or walk; after hemorrhage or sexual excesses.

Face pale, hippocratic; eyes sunken and surrounded by blue margins; pale, sickly expression as after excesses; toothache while nursing the child.

Excessive flatulence of stomach and bowels; belching gives no relief (Lyc., Pod.—gives relief, Carbo v.); < after eating fruit.

Colic: at a certain hour each day; periodical, from gallstone (Card. m.); < nights, after eating; > bending double.

Labor-pains cease from hemorrhage; cannot bear to be touched, not even her hands.

Hemorrhages: from mouth, nose, uterus or bowels; long continued; longing for sour things; blood dark, or dark and clotted, with ringing in the ears, fainting, loss of sight, gen- eral coldness and sometimes convulsions (Fer., Phos.).

Relations

Complementary: Ferrum.

Aggravation

From slightest touch; every other day; draft of air; milk; at night; after the chills; mental emotion.

Amelioration

Warmth; during rest; pressure; bending double

Type

Variable. Tertian or double tertian; quotidian or double quotidian; double quartan; malarial; remittent.

Anticipates from two to three hours each attack (Quinine).

"Paroxysm every seventh day, anticipating about three hours each succeeding chill"—W. J. HAWKES.

Time

Not characteristic; may begin at any hour of day; gen- erally toward midday; never at night. 5 P. M., 5 A. M. Parox- ysms return every seven or every fourteen days (Ars., Puls.).

Cause

Paludal fevers have always been considered its special domain. A change of theory may revolutionize the cause to which Cinchona is now supposed to be especially adapted; but thanks to similia it will not in the least affect its homœopathic indications.

Prodrome

Great thirst (Caps., Eup., Puls.—thirst and bone pains, Eup.); canine hunger; nausea; anguish; headache; debility; palpitation of the heart, with anxiety; sneezing when exposed to cold air; oppressive colic; and a general feeling of ill- ness.

"Restless sleep night before the paroxysm."—HAHNEMANN.

Chill

Without thirst\* (with thirst, Caps., Ign., Quin.).

Thirst ceases as soon as chill begins. General shaking chill over whole body, beginning in the legs below the knees, increased by drinking. Shivering or chilliness, with goose-flesh, after every swallow of drink (abstains from drinking because every swallow

\ Observation by Hahnemann.—In all my observations I have found that the Cinchona fever is characterized by the thirst not appearing during the cold stage, either shuddering or chilliness; that, on the contrary, thirst came after the cold stage, or, which is the same thing, that thirst came shortly before the hot stage set in. increases the chill, Eup. perf.—because drinking causes vomiting, Ars.—shuddering and chill after every drink, Caps.—drinking makes headache and all symptoms unbearable, Cimex). Thirst before or after, but not during the chill. Coldness and shivering when walking in the open air at 5 P. M., disappearing in the room; an hour afterwards, great heat, especially in the face, increased on motion and on walking (Bry.); thirst follows an hour after the disappearance of the heat. Wants to be near the stove, but it increases the chill (Ipec.—relieved by heat of stove, Ign.—relieved by external heat, Ars.). Internal and violent chill, with icy cold hands and feet, and congestion of blood to the head. Chill with pain in the liver. Shaking chill and internal coldness for several hours; shivering over the whole body without thirst; coldness of the hands and feet even in a warm room; chill alternating with heat, skin cold and blue (Camph., Carbo v.—hands cold. nails blue, Nux). Sensation of internal coldness in upper abdomen, after every swallow of drink, and renewed on every inspiration. Coldness over whole body as if dashed with cold water* (Ant. t., Rhus). Paleness and icy coldness of the hands and feet, aggravated by walking; vertigo and paleness of the face.

With thirst (no thirst in regular chill). Febrile chill over the whole body from time to time during the day, especially upon forehead, which has cold sweat upon it; violent thirst a quarter of an hour after the first chill. (No thirst during chill or heat—which is long-lasting—in first paroxysm.) Cold hands in the evening, with hot cheeks; one hand is icy cold, the other warm; ice-cold feet, with warmth of rest of body. (This alternate heat of one part and coldness of another at same time belongs only to this paroxysm.)

Heat

Without thirst.\ General heat, with distended veins, congested headache, desire to uncover, but chilly when uncovered (chilly when uncovered in any stage of paroxysm, Nux). Canine hunger or aversion to food, pain in the region of the liver, back, chest, limbs; dryness of mouth and dry, burning lips, with redness of face and often delirium. Long-lasting heat, with sleep. Cough dry, spasmodic, fatiguing, with pain in both hypochondria and at pit of stomach (with stitching pain in chest, Bry.). Heat of the whole body, externally and internally, with swollen veins of the arms and hands*, without sweat or thirst. Heat of the whole body. aggravated by walking (relieved by walking, Caps.). Sensation of heat in abdomen as of hot water running down. The

\ Observation by Hahnemann.—There is likewise no thirst in the Cinchona fever during the hot stage, except some burning of the lips, or some dryness of the parts, which dryness accounts for the symptom; sensation of slight thirst during the hot stage; "the thirst accompanying flushes of heat." In the Cinchona fever thirst sets in after the hot, or, which is the same thing, during the sweating stage. cheeks are red and hot to the patient, although they are not warm.

If he eats in this stage, sleepy after eating. On the least movement an unpleasant sensation of heat in the head and stomach.*

"Entire absence of thirst during height of paroxysm." —**Ad.

Lippe.**

With thirst (no thirst in previous heat). Heat over the whole body, with fine, needle-like stitches in the skin, espe- cially of the throat, together with great thirst for cold water.

Heat alternating with the chill; some thirst for cold water with the chill; heat follows half an hour or an hour after the chill. A very transient sensation of heat over the whole body, with thirst for cold water. Sensation of flushes of heat, with thirst for cold drinks. Warmth and redness of the face, while the rest of the body was cold. The right hand is warm, the left cold; the hands are now warm, now cold; heat, with burning lips and thirst, fol- lowed by sweat; chill, with thirst; then heat, with thirst; the thirst continues even during the apyrexia. Violent desire for cold drinks, accompanied with stinging in various parts of the skin.

"The fever heat, accompanied with stinging over the whole body, seems to form an exception."—HAHNEMANN.

The symptoms occurring before the chill and during the sweat and apyrexia are alike in both paroxysms. The thirst during the chill, with alternate warmth and coldness of different parts at same time; the thirst during heat, with stinging or fine, needle- like stitches in skin, with heat of one part and coldness of another, are the characteristics of this paroxysm.

Sweat

With great thirst. The first indication of its ap- proach is the return of the thirst which preceded the chill, but which was absent during the cold and hot stages. Intense thirst during chill and especially during heat, positively contra-indicates

Cinchona.

Sweating during sleep. On being covered he sweats profusely all over; this he cannot avoid, although very trouble- some, he is so sleepy he cannot get up. Partial; cold; greasy, or as if mixed with oil; profuse and debilitating (profuse, but not de- bilitating, Samb.); sweat on the back or side on which he lies (sweat on the side not lain upon, Benz.). Profuse sweat over the whole body when walking in the open air (Bry.). Easily excited sweat during sleep and motion (excited by motion only, Bry.— relieved by motion, Caps.). The sweat parboils the skin (Canch. —parboils the fingers, Ant. c.). Often slow in becoming estab- lished, and frequently out of all proportion to the intensity of the cold and hot stages (see Eup.).

"The patient sweats profusely, especially on the back and neck, when he sleeps." —Hahnemann.

Tongue

White or yellow; thick, dirty coating. Taste: too acute. Bitter taste in the mouth. Indifference to all food, even when thinking of it. Toothache, especially when infant nurses

(Sil.).

Pulse

Quick, hard and irregular during chill and heat; slow, feeble in apyrexia, sometimes intermittent; more quiet after eat- ing; great swelling of the veins.

Apyrexia

Sweats easily; great debility and exhausting night- sweats continue, followed by ringing in the ears, and constricting sensation over vertex from ear to ear. A saffron yellowishness of the skin of scalp, face, neck, chest and abdomen (Chel.); with the characteristic anæmic and cachectic appearance, once seen, never forgotten. There is swelling of both hypochondria, which are painful to pressure and worse by motion, bending, or coughing.

Swelling, pain and pressure of epigastric region, with hyper- trophy of spleen Entire loss of appetite, with sinking feeling in stomach, or hunger easily satisfied. Bitter eructations and bitter vomiting (sour eructations and sour vomiting, Lyc.). The urine is scanty and turbid, with a yellow or brick-dust sediment; and general dropsical symptoms are often present. Bloated or tym- panitic abdomen, and hard spleen or liver in nursing children, with profuse sweating and great weakness (without profuse sweating, Ars.).

This constitutes the paroxysm of Cinchona. But Cinchona has also another, an exception to the rule (probably a secondary re- action) which is often confounded with Arsenicum; hence its notice in this place. It has only two different stages—Chill and

Heat.

Analysis

The paroxysm anticipates from two to three hours each attack (Chin. s.); returns every seven or fourteen days; never at night; sweats profusely all over on being covered, or during sleep.

The thirst of Cinchona is guiding.

Prodrome; with thirst, intense, long before the chill (Caps.,

Eup.).

Chill; no thirst, or it disappears as chill increases.

Heat; no thirst, as chill passes into fever thirst begins; as fever increases thirst decreases, when fever declines the thirst begins.

Sweat; with great thirst. No thirst during the nervous tension of chill and heat; great thirst during relaxation of sweat and before chill begins.

Marsh intermittents, with pains in region of liver, vomiting of bile and great anguish.

During apyrexia: exhausting sweats, anæmic and cachectic appearance; sensitiveness in hypochondria; scanty urine; loss of appetite; bloated abdomen.