Ipecacuanha ip.

Boger's Synoptic Key — Materia Medica

C. M. Boger · Boger's Synoptic Key — Materia Medica · A Synoptic Key of the Materia Medica, 1915 — the Materia Medica half

Region

MUCOUS MEMBRANES: DIGESTIVE. Stomach. RESPIRATORY. Lungs. Nerves: Pneumo - gastric. Spinal. Cutaneous. Umbilicus.

Worse

WARMTH; damp. Room. Overeating: Ices. Pork. Veal. Mixed or rich foods. Periodically. Quinine. Heat and cold. Recessions.

Better

Open air.

General

Profuse secretions. Foamy discharges, stool, etc. CONTINUOUS NAUSEA, gastric disturbances, BRIGHT RED, GUSHING HÆMORRHAGE (rapidly clotting), or shortness of breath accompany most complaints. Infantile convulsions.

Particulars

Cries, screams and is hard to please. Downward crushing in head, to root of tongue. Migraine. Occipital pain, < vomiting, during chill, etc. Gushes of tears. Conjunctivitis. Cold (r), ear. Nosebleed. Sneezing. Face pale; blue about eyes or lips; white linea nasalis. Clean or red, pointed tongue. NO THIRST. Sudden faintness. HORRID NAUSEA; not > vomiting. Vomiting; bilious; < stooping. Repugnance to food. Miserable sinking or hanging loose feeling at stomach. Griping, clawing or cutting at navel; toward uterus. Brown, grass or yellow-green, molasses-like or bloody stools. Balls of mucus in stools. Dysentery. Urging to urinate; bloody urine. Cutting in uterus (l to r). Uterine hæmorrhage; gasps with each gush of blood. Painless hoarseness. Larynx and chest tight, < least motion. Spasm of vocal cords. Gasps for breath. Asthma. Paroxysms of retching, incessant or SUFFOCATIVE cough; with every breath; stiffens out, turns red or blue and finally is nauseated, gags or vomits; < stepping into open air; > warmth and repose. Pertussis. LOOSE (coarse) RATTLE IN CHEST, WITHOUT EXPECTORATION. Broncho-pneumonia. Hæmoptysis. Pains from kidneys into thighs. Short chill; alternates with heat or with external heat (Ap.). One hand cold, other hot. Long heat; without thirst. Hands and feet drip cold sweat. Suppressed or mixed intermittents; nausea in all stages. Catarrhal or gastric fevers.

Related

Complementary: Ars. Cup. Related: Ant-t. Lob.

Keynotes and Characteristics with Comparisons of some of the Leading Remedies of the Materia Medica

H. C. Allen · Keynotes and Characteristics with Comparisons of some of the Leading Remedies of the Materia Medica · homeoint.org / Medi-T HTML text; edition not stated by the mirror (first edition 1898, Allen d. 1909)

Keynote

Adapted to cases where the gastric symptoms predominate (Ant. c., Puls.); tongue clean or slightly coated. In all diseases with constant and continual nausea. Nausea: with profuse saliva; vomiting of white, glairy mucus in large quantities, without relief; sleepy afterwards; worse from stooping; the primary effects of tobacco; of pregnancy. Stomach: feels relaxed, as if hanging down (Ign., Staph.); clutching, squeezing, griping, as from a hand, each finger sharply pressing into intestines; worse from motion. Flatulent, cutting colic about umbilicus. Stool: grassy-green; of white mucus (Colch.); bloody; fermented, foamy, slimy, like frothy molasses. Autumnal dysentry; cold nights, after hot days (Colch., Merc.). Asiatic cholera, first symptoms, where nausea and vomiting predominate (Colch.). Haemorrhage: active or passive, bright-red from all the orifices of the body (Erig., Mill.); uterine, profuse, clotted; heavy, oppressed breathing during; stitches from navel to uterus. Cutting pains across abdomen from left to right (Lach., - from right to left, Lyc.). Cough: dry spasmodic, constricted, asthmatic. Difficult breathing from least exercise; violent dyspnoea, with wheezing and anxiety about the stomach. Whooping-cough: child loses breath, turns pale, stiff and blue; strangling, with gagging and vomiting of mucus; bleeding from nose or mouth (Indigo). Cough, with rattling of mucus in bronchi when inspiring (Ant. t.); threatened suffocation from mucus. Pains as if bones were all torn to pieces (as if broken, Eup.). Intermittent fever: in beginning of irregular cases; with nausea, or from gastric disturbance; after abuse of, or suppression from quinine. Intermittent dyspepsia, every other day at same hour; fever, with persistent nausea. Oversensitive to heat and cold.

Relations

Complementary: Cuprum. Is followed well: by, Ars. in influenza, chills, croup, debility, cholera infantum; by Ant. t., in foreign bodies in larynx. Similar: to, Puls., Ant. c., in gastric troubles.

Aggravation

Winter and dry weather; warm, moist, south winds (Euph.); slightest motion.

Key-Notes to the Materia Medica

Henry N. Guernsey · Key-Notes to the Materia Medica · homeoint.org / Médi-T HTML text (Guernsey d. 1885; public domain)

General

One of the best guides to the use of this remedy is a constant but unavailable desire to vomit; or immediately after vomiting they wish to do so again; constant nausea.

Gastric

Disgust at the stomach (for food); empty vomiturition; vomiting in general; also of bile, and blood. No relief obtained by vomiting, the desire still remaining.

Chest

Suffocative attacks of breathing. Respiration oppressed; anxious; deep; quick; sighing; with concomitant complaints. Cough without expectoration; with bloody expectoration; without waking the patient.

Sexual

Threatened abortion; often with a sharp, or pinching pain around the umbilicus, which runs downward to the uterus, with constant nausea and discharge of bright, red blood; discharge of blood before the proper period; metrorrhagia, often after confinement, which is heralded by low pulse, nausea, etc.; there is a steady flow of bright, red blood, which may soak through the bed to the floor, or may run over the foot of the bed. (Where there is this steady flow of bright, red blood, give Ipec., and don't resort to applications, manipulations, etc.) Menstruation too early and too profuse; deficient labor pains, and with the pains there is a great deal of suffering, but no good is accomplished, the suffering is caused by the above pain about the umbilicus, running to the uterus.

Generalities

Blue color around the eyes. Stools bloody; fermented (like yeast); bleeding from inner parts, flowing all over the body; epilepsy with convulsive motion; external coldness of the skin; also of single parts; cold perspiration.

Worse

Periodically; from vomiting; from coughing; from the suppression of cutaneous eruptions; from taking veal; from abuse of Peruvian bark; from derangements of the stomach.

Remedies following

Bellad., Bryon., Chamom., Ignat., Nux vom., Pulsat., Veratr.

Antidotes

Arsen., China.

Seven Hundred Red Line Symptoms from Materia Medica

J. W. Hutchison · Seven Hundred Red Line Symptoms from Materia Medica · rewritten from Hering's and other materia medicas

Red line symptom

Headache, as if the brain were bruised, all through the bones of the head, and down into the root of the tongue, with nausea. Distressing nausea, and inclination to vomit, with almost all complaints. Stooping causes him to vomit. Distressing feeling, as though the stomach were hanging down relaxed. With every movement a cutting pain in abdomen, almost constantly running from left to right Stools as if fermented, green as grass, with nausea and colic. Hemorrhage from the uterus, blood bright red, profuse, clotted with heavy oppressed breathing. Suffocation threatens from constriction in the throat and chest, worse from the least motion. Loses breath with the cough, turns pale and becomes rigid. One hand cold, the other hot. Backache, short chill, long fever, mostly heat with thirst, headache, nausea, cough and sweat last.

Homœopathic Materia Medica

William Boericke · Homœopathic Materia Medica · 9th edition

Common name

Ipecac-root (IPECA)

General

The chief action is on the ramifications of the pneumogastric nerve, producing spasmodic irritation in chest and stomach. Morphia habit. The principal feature of Ipecacuanha is its persistent nausea and vomiting, which form the chief guiding symptoms. Indicated after indigestible food, raisins, cakes, etc. Especially indicated in fat children and adults, who are feeble and catch cold in relaxing atmosphere; warm, moist weather. Spasmodic affections. Hæmorrhages bright-red and profuse.

Mind

Irritable; holds everything in contempt. Full of desires, for what they know not.

Head

Bones of skull feel crushed or bruised. Pain extends to teeth and root of tongue.

Eyes

Inflamed, red. Pain through eyeballs. Profuse lachrymation. Cornea dim. Eyes tire from near vision. State of vision constantly changing. Spasm of accommodation from irritable weakness of the ciliary muscle. Nausea from looking on moving objects.

Face

Blue rings around eyes. Periodical orbital neuralgia, with lachrymation, photophobia, and smarting eyelids.

Nose

Coryza, with stoppage of nose and nausea. Epistaxis.

Stomach

Tongue usually clean. Mouth, moist; much saliva. Constant nausea and vomiting, with pale, twitching of face. Vomits food, bile, blood, mucus. Stomach feels relaxed, as if hanging down. Hiccough.

Abdomen

Amebic dysentery with tenesmus; while straining pain so great that it nauseates; little thirst. Cutting, clutching; worse, around the navel. Body rigid; stretched out stiff.

Stools

Pitch-like green as grass, like frothy molasses, with griping at navel. Dysenteric, slimy.

Female

Uterine hæmorrhage, profuse, bright, gushing, with nausea. Vomiting during pregnancy. Pain from navel to uterus. Menses too early and too profuse.

Respiratory

Dyspnœa; constant constriction in chest. Asthma. Yearly attacks of difficult shortness of breathing. Continued sneezing; coryza; wheezing cough. Cough incessant and violent, with every breath. Chest seems full of phlegm, but does not yield to coughing. Bubbling rales. Suffocative cough; child becomes stiff, and blue in the face. Whooping-cough, with nosebleed, and from mouth. Bleeding from lungs, with nausea; feeling of constriction; rattling cough. Croup. Hæmoptysis from slightest exertion (Millef). Hoarseness, especially at end of a cold. Complete aphonia.

Fever

Intermittent fever, irregular cases, after Quinine. Slightest chill with much heat, nausea, vomiting, and dyspnœa. Relapses from improper diet.

Sleep

With eyes half open. Shocks in all limbs on going to sleep (Ign).

Extremities

Body stretched stiff, followed by spasmodic jerking of arms towards each other.

Skin

Pale, lax. Blue around eyes. Miliary rash.

Modalities

Worse, periodically; from veal, moist warm wind, lying down.

Relationship

Compare: Emetine-principal alkaloid of Ipecac (A powerful amebicide, but is not a bactericide. Specific for amæbiasis; of remarkable value in treatment of amæbic dysentery; also as a remedy in pyorrhea, 1/2 gr daily for three days, then less. Emetin, 1/2 gr hypodermically, in Psoriasis. Emetin hydroch. 2x, diarrhœa with colicky, abdominal pains and nausea. Emetin for endamoebic dysentery. In physiological doses must be carefully watched. May produce hepatization of lungs, rapid heart action, tendency for the head to fall forward and lobar pneumonia. In hæmatemesis and other hæmorrhages, compare: Gelatin which has a marked effect on the coagulability of the blood. Hypodermically; or if by mouth, a 10 per cent jelly, about 4 oz, three times a day) Arsenic; Cham; Puls; Tart em; Squill. Convolvulus (colic and diarrhœa). Typha latifolia-Cat-tail flag (dysentery, diarrhœa) and summer complaint. Euphorbia hypericifolia--Garden Spurge--(Very similar to Ipecac. Irritation of the respiratory and gastro-intestinal tracts and female organs). Lippia mexicana--(Persistent dry, hard, bronchial cough--asthma and chronic bronchitis).

In Asthma, compare: Blatta orientalis.

Antidotes: Arsenic; China; Tabac.

Complementary: Cuprum; Arn.

Dose

Third to 200th potency.

Leaders in Homoeopathic Therapeutics

E. B. Nash · Leaders in Homoeopathic Therapeutics · homeoint.org / Médi-T HTML text (Nash d. 1917; public domain)

Leaders

Persistent nausea, which nothing relieves, in many complaints.

Headache as if bruised, all through the bones of the head, down into root of tongue, with nausea.

Stools as if fermented, or as green as grass, with colic and nausea.

Hæmorrhages from uterus; profuse, bright blood and heavy breading with nausea.

Spasmodic, or asthmatic cough; great depression and wheezing breading; child becomes rigid and turns blue.

Backache, short chill, long fever, heat usually with thirst; raging headache, nausea; and sweat last; nausea during pyrexia.

Better than Quinine, in intermittents, or after its abuse, the symptoms agreeing.

Ipecacuanha leads all the remedies for nausea. Any complaint accompanied with persistent nausea, the patient not being at all relieved by vomiting, just as sick after as before-this is what we mean by persistent nausea. This should at once call attention to this remedy. It is often found in connection with gastric troubles from dietetic errors, and the choice will sometimes be between Ipecacuanha and Pulsatilla, because both are useful in gastric disturbances caused by indulgence in mixed diet -pastry, ice-cream, pork, fatty food, etc. Pulsatilla may be considered the better, while the food is in the stomach. Ipecacuanha after it is out, but the nausea persists notwithstanding.

Again, with Pulsatilla the tongue is often coated, like Antimonium crudum, while with Ipecacuanha there may be a slight coating, or the tongue may be perfectly clean. This vomiting with clean tongue, however, is not an infallible indication for Ipecacuanha, for we sometimes find it in connection with worm symptoms, where Cina has it just as prominently, and is the remedy. Digitalis also has it in heart disease. Ipecacuanha affects the whole intestinal tract. One very characteristic symptom is that the stomach and bowels feel as if relaxed and hanging down.

There are three kinds of looseness of the bowels, or rather three characteristic stools:

1. Fermented stools-foamy, like yeast.

2. Grass-green stools -mucous or watery.

3. Slimy stools -dysenteric, with more or less blood.

All these stools are found very often in children, especially in summer time, often as a consequence of overeating or wrong eating, when a dose of Ipecacuanha 200th will set matters to rights, and prevent the little patient from running into so-called cholera-infantum or enterocolitis, which often becomes a very serious and obstinate affection. The characteristic nausea is a sure indication.

We will also find this nausea present, where this remedy is the "proper caper," in headaches. Headache, as if bruised, all through the bones of the head, and down into the root of the tongue. This kind of headache may be of rheumatic origin, but the nausea is there just the same, if Ipecacuanha is to cure. Then we have a sick headache of gastric origin, the nausea beginning before the pain in the head, and continuing all through. In what seems to be hydrocephaloid with this nausea, Ipecacuanha has often cleared up the whole case in a few hours.

Again, we find the nausea accompanying the cough in the affections of the respiratory organs. Also in the hæmorrhages and in the fevers in which it is often indicated. In short, we cannot do better than to use Hering's expression: "Nausea, distressing, constant, with almost all complaints, as if from the stomach, with empty eructations, accumulation of much saliva, qualmishness and efforts to vomit," nothing relieves.

During the nausea, the face is generally pale, eyes sunken, with blue margins, and often there is more or less twitching of face and lips, and sleepiness after vomiting. We have a great many remedies that are powerful emetics, like Antimonium tartaricum, Zinc sulphate, Lobelia and Apomorphine; but, so far as I know, the nausea is not so persistent, nor is it found in connection with so many other affections. Of course, no single symptom, however strong, would justify a prescription, if there were other symptoms just as strong in the same case.

For instance, if there were burning in the stomach, intense thirst, but could not drink, great restlessness and prostration, we would think of Arsenicum album, and it is often the best remedy to follow Ipecac., if the case goes from bad to worse.

Ipecacuanha affects the mucous lining of the respiratory organs, almost as prominently as it does that of the alimentary tract.

There is a great accumulation of mucus, which loads up the air cells and bronchi, until there seems to be great danger of suffocation. Note the symptoms:

"Violent degree of dyspnœa, with wheezing and great weight and anxiety about the prœcordia." (Antimon. tart., coarse rattling.) "Threatened suffocation from accumulation of mucus."

This excessive accumulation of mucus in the air passages seems to excite spasm like a foreign body, and an asthma, or spasmodic cough, or both together, ensue. But the spasmodic cough and asthma do not seem to all depend upon accumulation of mucus, for Ipecacuanha is often our best remedy in the first stage of both asthma and whooping cough, before the stage when the mucus is present.

Again, "Suffocating cough, whereby the child becomes quite stiff and blue in the face."

"Whooping cough, with nosebleed (Indigo), bleeding from the mouth, vomiting, loses breath, turns pale or blue, and becomes rigid."

Infantile pneumonia. with chest loaded with mucus, rapid, wheezing respiration, surface blue, face pale, finds a very effectual remedy in Ipecacuanha. Old people with emphysema form chronic asthma are also > by Ipecac. So that we might narrow down the respiratory troubles to two conditions:

1st, Those in which excessive accumulation of mucus characterized the case.

2nd, Those in which spasm was the characteristic feature.

Of course, all the symptoms must be taken into consideration, in order to differentiate between Ipecacuanha and other remedies having the same objective states and conditions.

The control that this remedy has over hæmorrhages deserves honorable mention It has hæmorrhages from the nose, stomach, rectum, womb, lungs and bladder; from all the orifices of the body. So does Crotalus, but the blood in Ipecacuanha is bright red, not decomposed. Sulphuric acid also has hæmorrhages from all the outlets of the body, but the other attending symptoms are different. With Ipecacuanha, the hæmorrhages are active, profuse, bright red. It is a better remedy than Secale ever was or can be, for post-partum hæmorrhages, and it is not necessary to use it in large and poisonous doses, for it will stop them in the 200th potency, and is quicker in its action than Secale. Let us notice a few remedies for hæmorrhages:

Ipecacuanha. Bright red, profuse, with heavy breathing and nausea.

Aconitum. Active, bright, with great fear and anxiety.

Arnica. From injuries, bodily fatigue, physical exertion.

Belladonna. Blood hot, throbbing carotid, congestion to head.

Carbo vegetabilis. Almost entire collapse, pale face, wants to be fanned.

China. Great loss of blood, ringing in ears, faintness.

Crocus. Blood clots in long, dark strings.

Ferrum. Partly fluid, partly solid, very red face, or red and pale alternately.

Hyoscyamus. Delirium, and jerking, and twitching of muscles.

Lachesis. Blood decomposed, sediment like charred straw.

Crotalus, Elaps and Sulphuric acid. Black fluid blood, the first and last from all outlets.

Nitric acid. Active hæmorrhages of bright blood.

Phosphorus. Profuse and persistent, even from small wounds and tumors.

Platinum. Partly fluid, acid partly hard black clots.

Pulsatilla. Intermittent hæmorrhages.

Secale. Passive flow in feeble, cachectic women.

Sulphur. In psoric constitutions; other remedies fail.

Other remedies and indications might be added here, but hæmorrhage is only one symptom, and never alone furnishes a reliable indication for any remedy. But Ipecacuanha is one of the best if indicated.

Ipecacuanha is a well-known intermittent fever remedy in our school. Jahr recommends it in the beginning of all cases, unless there are special indications for some other remedy, and says "By pursuing this course I have cured many cases of fever and ague by the first prescription, thus saving myself a good deal of unnecessary seeking and comparing." Whatever may be said in condemnation of this loose prescribing, it is certainly preferable to the inevitable Quinine prescription of the old school, and some self-styled homœopaths, for the reason that it will cure more cases than Quinine, and do infinitely less harm. Ipecac. can cure more cases than Quinine, but both can cure the case to which they are homœopathic, and that in the potentized form of the drug. We have such clear-cut indications for the use of many remedies that we need not fail once where the allopaths do twenty times, with their indiscriminate Quinine treatment.

The whole case generally revolves around one to three guiding symptoms, for instance: Ipecac. The persistent nausea in one or all stages.

Arsenicum alb. Irregularly developed paroxysm; thirst intense during heat, for small quantities.

Eupator. perf. Bone pains; vomits bile at end of chill, 7 to 9 A. M.

Ignatia. Chill, with red face, > by external heat: frequent sighing.

Capsicum. Chill begins between shoulder blades and spreads.

Nux vomica. During heat can't uncover in least, without chill.

Nat. Mur. Chill 10 to 11 A. M.; bursting headache during heat; sweat >; after Quinine.

Rhus tox. Cough in chill; restless and dry tongue in heat; tossing about.

Podophyllum. Great loquacity during chill and heat; jaundice.

Antimonium tart. Great sleepiness during heat and sweat, with pale face.

These characteristics are genuine and reliable, and many more might be added if we had time and space, but they can all be found in H C Allen's work on Fevers. They show how different the remedies, and how particular the true prescriber must be, when selecting his remedy for this, as well as other diseases. Remittents also often come under the control of this remedy.

Text Book of Materia Medica

Adolph Lippe · Text Book of Materia Medica · homeoint.org / Médi-T HTML text (Lippe d. 1888; public domain)

Mind and Disposition

Irritability ; restlessness, impatience. Ill-humor and despising every thing. Cannot endure the least noise.

Head

Vertigo, when walking and when turning round. Stitches, in the vertex (or forehead). Headache, as if the skull and brain were bruised, with nausea and vomiting. Pain in the occiput and nape of the neck.

Eyes

Twitching of the eyelids. Pupils dilated. Obscuration of sight ; red, inflamed eyes.

Ears

Coldness and chilliness of the ears (during the febrile heat).

Nose

Bleeding of the nose. Loss of smell. Coryza, with stoppage of the nose.

Face

Pale face with blue margins around the eyes. Convulsive twitches in the muscles of the face and lips. Red skin around the mouth. Smarting eruption and aphthæ on the margin of the lips. Rash in the face.

Mouth and Throat

Pain in a hollow tooth, when biting on it, as if it were extracted. Smarting in the mouth and on the tongue. The tongue is coated yellowish or white. Spasmodic contractive sensation in the throat. Fauces, stinging, rough, sore and dry. Copious secretion of saliva.

Stomach and Abdomen

Want of appetite ; the stomach feels relaxed. Aversion to all food. Desire for dainties and sweet things. Thirstlessness. Bad effects from eating pork. Sweetish, bloody taste in the mouth. Nausea, as if proceeding from the stomach, with empty eructations and accumulation of much saliva. Nausea and retching from drinking any thing cold and from smoking tobacco. Vomiting of all the ingesta. Vomiting of bile ; green, jelly-like mucus. Vomiting of blood ; black, pitch-like substances. Sensation of emptiness and relaxation of the stomach. Horrid, indescribable pain and sick feeling in the stomach. Cutting and pinching (as if grasping with the hands) around the umbilicus ; aggravated by motion, ameliorated by rest. Flatulent colic, with frequent diarrhœic stools.

Stool and Anus

Diarrhœa stools as if fermented with nausea and colic ; stools green as grass. Dysenteric stools, with tenesmus. Feces covered with bloody mucus. Bloody stools. Stools smelling putrid.

Urinary Organs

Scanty urine, dark-red. Unsuccessful urging to urinate. Hæmaturia, with cutting in the abdomen and in the urethra. Turbid urine, with brick-dust sediment.

Sexual Organs

Women. Menstruation too early and too profuse. Metrorrhagia ; blood bright-red, clotted, with oppressed breathing.

Respiratory Organs

Quick, anxious breathing. Sighing breathing. The breath smells fetid. Suffocative attacks in the room ; better in the open air. Suffocative feeling from the least motion. Spasmodic asthma, as from constriction in the chest and throat. Contraction of the chest, with short and panting breathing. Dry cough, caused by a tickling, especially in the upper part of the larynx. Frequent attacks of spasmodic cough, shaking, racking, hollow, quickly following coughs from tickling in the upper part of the larynx, as from vapor of sulphur ; with expectoration of blood with mucus in the morning. Suffocative cough ; the child becomes quite stiff, and blue in the face. Suffocative cough in the evening ; continuous cough, with perspiration on the forehead, shocks in the head, retching and vomiting. Hæmoptysis from the slightest exertion. Rattling noise in the bronchial tubes when drawing breath.

Back and Neck

Swelling and suppuration in the throat-pit. Opisthotonos and emprosthotonos. Cramp pain between the scapula during motion.

Extremities

Upper. Coldness of one hand while the other is hot. Lower. Convulsive twitching in the lower limbs and (not in the upper). Cramps in the thighs, at night, with lump in the thighs. Itching of the calves. Ulcers on the foot with a black base. Sensation in the femur, as if dislocated on sitting down.

Sleep

Sleeplessness. Sleeps ; with the eyes ; half open ; moans and groans. Starts frequently in his sleep.

Generalities

Great weakness and aversion to all food ; nausea ; with almost all ailments. Hæmorrhages from all the orifices of the body. Sensation as if the joints had gone to sleep. Over-sensitiveness to heat and cold. Twitching in the limbs. Spasm, bending the body forward or backward. The body is stretched out stiff.

Skin

Rash (in lying-in women) ; suppressed rash. Itching of the skin, with nausea ; has ; to scratch till he vomits.

Fever

Pulse very frequent, but at times scarcely perceptible. Chill of short duration and soon changing to heat. Internal chilliness, as if under the skin, aggravated from heat. Chill with thirst. Damp coldness of the hands and feet. After a short chill dry heat, with parchment-like skin. Sudden attacks of general heat, with cold hands and feet. During the heat no thirst. Violent perspiration, principally during the night. Perspiration smelling sour (with turbid urine). Sudden attacks of hot perspiration (in the room). Intermittent fever; nausea and vomiting predominate ; slight chills are followed by much heat, with thirst and no subsequent perspiration, -consequent upon the abuse of Quinine; slight chilliness without thirst ; afterwards violent heat, with thirst, nausea and vomiting, dyspnœa, stitches in the chest, finally copious perspiration.

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

Cephaëlis ipecacuanha. N. O. Rubiaceæ. Tincture and trituration of the dried root.

Clinical

Anæmia. Asthma. Bronchitis . Catarrh. Cholera. Consumption . Convulsions. Cough . Deafness. Diarrhœa . Dysentery. Enteric fever . Eyes, affections of. Gall-stone colic. Gastric Ulcer. Hæmatemesis. Hæmorrhage . Hæmorrhoids. Hysteria. Intermittent fever. Menstruation, disorders of . Opium habit. Pregnancy, disorders of. Remittent fever . Salivation. Tetanus. Toothache. Vomiting. Whooping-cough . Worm-fever. Yellow-fever.

Characteristics

The well-known emetic effect of Ipecacuanha Wine gives a rough keynote for the use of Ipec . in homœopathy. Wherever ailments are associated with the presence of constant nausea Ipec . is very likely to be of use. The special form of nausea is a constant but unavailing desire to vomit; or immediately after vomiting there is, instead of relief, a desire to vomit again. With this there is a clean or not very dirty tongue. There is profuse salivation with the nausea. The nausea of Ipec . is oftenest met with in affections of the stomach and bowels, of the respiratory organs, and in fevers. In the stomach itself there is a symptom which is very characteristic of the remedy, a feeling "as if the stomach were hanging down relaxed." There is disgust at the stomach for food; empty vomiting; vomiting of bile; of blood. No > by vomiting. The stomach disorder may be occasioned by rich food-pork, pastry, fruits, candy, ice-cream. The stomachic disgust of the remedy is depicted on the countenance, which expresses nausea. The corners of the mouth are drawn down. Blue rings round the eyes. Sometimes the mental state corresponds: "Moroseness and contempt for everything"; "Disdainful humour." The irritability of the elders becomes in children crying and screaming. Another mental symptom is "full of desires they know not for what." Ipec . is a botanic relative of China , and it is also an antidote to the latter; (it is also closely allied to Viola odorata ). Perhaps the relationship of Ipec . to China may have something to do with its large sphere of usefulness in intermittent fever. Jahr recommended that in all cases of intermittents in which no other remedy is particularly indicated Ipec . should be given to begin with. It will either cure the case or bring out more definitely indications for another remedy. I have frequently found this advice useful; and it occurs to me that as most intermittents have been treated with quinine it is through its antidotal properties that Ipec . exerts some of its good effects. It has a strongly marked periodic action. A special indication for it is: Nausea through all the stages. Other indications are: "Stages completely mixed up short chill, followed by long fever." Ipec . has many bone pains, in the head and elsewhere. Pains as if bones were all torn to pieces. Ipec . is given as an expectorant in old-school practice, and is supposed to act by its nauseating properties. But homœopaths have proved that nauseating doses are neither necessary nor desirable. The cough of Ipec . is dry, spasmodic, constricted, asthmatic. "Violent degree of dyspnœa, with wheezing and great weight, and anxiety about the precordia." "Threatened suffocation from accumulation of mucus." In whooping-cough a characteristic is the spasmodic rigidity of the patient. "Child loses breath, turns pale, stiff, and blue; strangling with gagging and vomiting of mucus; bleeding from nose or mouth." The great keynote, subject to slight variations, is ─ mental depression with tissue irritability. The tissue irritability of Ipec . is severe and urgent, but superficial; that of Ars ., deep-seated, diffuse, and burning; that of Ferrum involves tissue, as with Ars ., but is mostly painless (Cooper). Ipec . is a medicine of great importance in hæmorrhages. The blood is bright red and the flow steady. A grand keynote for Ipec . in hæmorrhages (whether of lungs, bowels, uterus, or other parts) is nausea with the hæmorrhage . Guernsey thus describes the effect of Ipec . in the female sexual sphere, in which the hæmorrhagic power of the remedy is of the highest importance: "Threatened abortion; often with a sharp pain around the umbilicus, which runs downward to the uterus, with constant nausea and discharge of bright red blood; discharge of blood before the proper period; metrorrhagia, often after confinement, which is heralded by a low pulse, nausea, &c.; there is a steady flow of bright red blood, which may soak through the bed to the floor, or may run over the foot of the bed. (Where there is this steady flow of bright red blood give Ipec ., and do not resort to applications, manipulations, &c.) Menstruation too early and too profuse; deficient labour pains, and with the pains there is a great deal of suffering, but no good is accomplished, the suffering is caused by the above-named pain about the umbilicus, moving to the uterus." Some of the pains of Ipec . run from above down; some from left to right (cutting pain in abdomen). There is a remarkable headache "as if bruised, all through the bones of the head and down into the root of the tongue." Nausea is generally an accompaniment. Brain feels bruised, pain piercing to roots of teeth. There is also a sick headache originating in the stomach, the nausea preceding the headache and persisting all through. Teste has used the remedy with good effect in "constrictive and contusive headaches seated in left parietal region, coming on every day at 11 a.m., increasing gradually until the pain became intolerable, then decreasing in the same manner" and ceasing completely at 2 p.m. Another sphere in which Ipec . has shown great curative power is the eye. According to Allen granulations of the lids have been cured by the instillation of the dilutions. Also subacute inflammation of the cornea, with intense pain and great photophobia. Pustular conjunctivitis, especially in children. Inflammation with tearing pain and gushing of tears. Violent neuralgia of eyeballs, shooting in the head, with gushes of tears, nausea, &c. Dr. Nancy T. Williams ( H. R ., xi. 65) has cured several cases of gall-stone colic with Ipec . 6. The relief was prompt and lasting. On the strength of this symptom of Hahnemann's, "external chilliness with internal heat," Mahony gave Ipec . 200 to an army sergeant, 49, invalided for aneurism, who had this symptom while recovering from a catarrhal attack: coldness of hands and feet not perceptible to himself. Ipec . soon removed this. ( Med. Adv ., xxvi. 110). J. R. Haynes (quoted B. J. H ., xxxvii. 203) uses Ipec . as an antidote to the Opium and Morphia habit. He gives five drops of Ipec . Ø for every grain of Morphia (or its equivalent in Opium ) which the patient has been accustomed to take. When a definite sequence is observed in the order of occurrence of symptoms this is of great practical importance. Woodward ( Hahn. Adv ., May, 1900, p. 278) has noted in twenty-three provers the symptoms of Ipec . develop in this order: ( 1 ) Gastric; ( 2 ) Respiratory; ( 3 ) Spinal; ( 4 ) Genito-urinary; ( 5 ) Cutaneous. In several instances, however, the cutaneous symptoms appeared before the genito-urinary. Owing to its immediate expulsive effect, given internally, upon the mucous membrane, its influence upon the skin has not been sufficiently considered. Mixed with oil, powdered Ipec . has been used to vesicate the skin; and, diluted, the tincture is used for the bites of insects, bee- and wasp-stings, &c. It produces violent irritation of the skin, and between the acts of vomiting an uncontrollable desire to scratch is often felt in those under the influence of material doses. Cooper cured an immense uterine fibroid where persistent painful irritation of the skin with constant retching and vomiting, made worse by eating, constituted the prominent symptom. Frightful irritation inside and out, especially vaginal, with thick leucorrhœa, and a feeling of desperation, yields to Ipec. Ipec . has been used locally and internally for malignant pustule and anthrax, in which disease Dr. Edwin Muskett considers it specific ( Alleg. Hom. Zeitung ., No. 23, Dec., 1888). In certain forms of peripheral neuritis it deserves more consideration than has hitherto been allotted to it (Cooper). In consequence of its proved cholagogue action, it constitutes nowadays a very frequent constituent of allopathic pills. Ipec . has much of the sensitiveness of Chi . ─ There is < by touch. Over-sensitiveness to heat and cold. < In winter and dry weather. < In warm, moist wind (catarrh, asthma, &c.). Chill is < in warm room; by external heat. Summer heat or hot room = fainting. Drinking > chill. Cold water > spasmodic cough. Cold drinks or ice-creams = colic. < Periodically; by vomiting; by coughing; by suppression of eruptions. < From veal from rich food (pork, fat, pastry); from ices.; lemon-peel; raisins salads, < By eating. < From abuse of quinine. < By motion. > By rest; by pressure; by closing eyes. Ipec., according to Hahnemann, is a short-acting medicine. It is specially suited to stout persons of lax fibre; to fair people; to women and children to emphysematous persons; to persons who have a history of epistaxis or other blood-loss.

Relations

Antidoted by: Arn., Ars., Chi., Nux, Tab. It antidotes: Alum., Apis, Arn., Ars., Chi., Copper fumes, Dulc., Fer., Lauro., Op., Sul. ac., Tab., Ant. t. Followed well by: Ars. (cholera infantum; debility; colds; croup; chills); Bell.; Bry.; Cadm. s. (yellow fever); Calc., Cham., Chi., Cupr., Ign., Nux, Pho., Puls., Sep., Sul., Ant. t., Tab., Ver. Complementary: Cupr. Compare: Cough after eating, Nux; ( whilst eating and in open air, Calc.). One hand cold, the other hot, Chi., Dig., Pul., Mosch. Constant nausea, Cocc., Kali c., Sul., Ign., Acet. ac. Salivation lying down ─ Ipec.; (on lying down at night, Cham., Nux, Pho., Rhus). Grass-green stools, Arg. n. Expression of nausea, Æthus., Ant. t. Bruised headache, Ptel., Ver. (bruised feeling here and there in brain). Gastric disturbance from rich food, Pul. (but Pul. has foul tongue, Ipec. clean; with Pul. symptoms last only whilst food is in stomach, Ipec. when stomach is empty). Stomach relaxed, Staph., Lobel., Tab. Asthma, Cupr. (spasmodic element predominates), Lob. (with a weak sensation in epigastrium spreading up into chest. Whooping-cough with rigidity, Cina (clucking sound down œsophagus as child comes out of paroxysm; grinds teeth), Cupr. (spasms of flexors predominate). Vomiting, Ant. t. (Ipec. has more nausea, Ant. t. more vomiting and retching; Ipec. has clean or slightly-coated tongue, Ant. t. thickly-coated white; both have vomiting after a meal, after acids and after coughing). Pains fly from left to right. Lach. (side to side, Act. r.; right to left, Lyc.; with nausea, Ipec.). Chest affections from retrocession of measles rash, Bry. Asthma, œdema, Linum n. Sweetish, bloody taste, Berb. (also bitter taste; Berb. mouth is pasty or sticky, Ipec. more generally clean; Berb. has dry mouth, Ipec. increase of saliva and smarting in mouth and tongue).

Causation

Vexation and reserved displeasure. Injuries. Suppressed eruptions. Quinine. Morphia. Indigestible foods.

Mind

Cannot endure the least noise. ─ Cries and howling (of children). ─ Anxiety and fear of death. ─ Moroseness, with contempt for everything. ─ Disdainful humour. ─ Desire for a number of things, without knowing exactly which. ─ Irritability, and disposition to be angry. ─ Ailments from mortification or vexation, with indignation. ─ Impatience. ─ Slowness of conception.

Head

Vertigo when walking, and when turning round, with tottering and staggering. ─ Pain, as of a bruise, in all the bones of the head, as far as the root of the tongue (with nausea and vomiting). ─ Headache as of a bruise of the brain and skull, which pierces through all the cranial bones into roots of teeth, with nausea. ─ As if brain compressed. ─ Attacks of headache, with nausea and vomiting. ─ Tearing in the forehead, excited or aggravated by being touched. ─ Lancinating headache, with heaviness of the head. ─ Stitches in the vertex (or forehead). ─ Painful pressure on the forehead. ─ Pain in the occiput and nape of the neck. ─ Hydrocephaloid.

Eyes

Eyes red and inflamed. ─ Neuralgia of eyes, esp. r., extended to nose and mouth; in evening biting and pressure in eyes; he was awakened between 2 and 3 a.m. by tearing pains in eyes, esp. r., radiating to forehead and driving him out of bed, < from strong light, accompanied by chilliness, heat, sweat. ─ Eyelids closed, painful expression of face; the pillow was soaked with tears which flowed freely on opening r. eye. ─ Twitching of l. upper lid with three black spots before sight on lifting lid. ─ Scrofulous ophthalmia, pain in forehead and temples, photophobia and corneal ulceration. ─ Conjunctiva rose-coloured; cornea opaque; sight gone from r. eye, could not read, evening, from being dazzled by candle-light, which appeared multiplied five or six times; next morning fiery iridescent rings before l. eye, which had been less affected. ─ Humour in the corners of the eyes. ─ Trembling of the eyelids. ─ Twitching of the eyelids. ─ Hardened mucus in the external canthi. ─ Pupils dilated. ─ Confused sight.

Ears

Coldness and chilliness of the ears (during the febrile heat).

Nose

Epistaxis. ─ Loss of smell. ─ Coryza, with stoppage of the nose.

Face

Pale, earthy, or yellowish colour of the face, which is bloated, with livid circles round the eyes. ─ Convulsive startings of the muscles of the face. ─ Lips covered with small aphthæ and eruptions. ─ Rash in the face. ─ Fine branny eruption on face, with or without irritation. ─ Pityriasis. ─ Pain, as from excoriation, in the lips. ─ Convulsive startings of the lips. ─ Redness of the skin round the mouth.

Teeth

Odontalgia by fits, as if a tooth were being extracted. ─ Toothache > while eating; < afternoon and night. ─ Toothache < by day; pain every few minutes with a jerk radiating into r. temple and nose, as if tooth being extracted. ─ The neuralgic pains of Ipec . and of Viol. od . often make for r. temple (Cooper). ─ Dentition.

Mouth

Painful sensibility of all parts of the mouth. ─ Smarting in mouth and on (margins of) tongue. ─ Copious secretion of saliva. ─ Constantly obliged to swallow saliva. ─ Saliva runs from mouth on lying down. ─ Tongue: clean; white or yellow; pale.

Throat

Sore throat, during deglutition, as from swelling of the pharynx. ─ Difficult deglutition, as from paralysis of the tongue and of the gullet. ─ Spasmodic contractive sensation in the throat. ─ Fauces, stinging, rough, sore, and dry.

Appetite

Insipid and clammy, or bitter taste, esp. in the morning. ─ Sweetish taste, as of blood in the mouth. ─ Desire only for delicacies and things sweetened with sugar. ─ Want of appetite; the stomach feels relaxed. ─ Bad effects from eating pork, veal, &c. ─ Gastric catarrh from indigestible food, or from ice-cold things. ─ Adipsia. ─ Beer has an insipid taste. ─ Tobacco smoke is nauseous, and causes vomiting. ─ Great repugnance and dislike to all food. ─ Water-brash.

Stomach

Nausea, as if proceeding from the stomach, with copious salivation, violent itching in the skin, and empty risings. ─ Retching, esp. after drinking anything cold, or after smoking. ─ Vomiting of drink, and of undigested food; or else of bilious, greenish, or acid, or mucous, gelatinous matter, sometimes immediately after a meal. ─ Vomiting of blood. ─ Vomiting, with sweat, heat, fetid breath, and thirst. ─ Vomiting with diarrhœa. ─ Vomiting on stooping. ─ Vomiting of black matter, like pitch. ─ Sensation of excessive uneasiness in the stomach and epigastrium. ─ Horrid, indescribable pain and sick feeling in the stomach. ─ Sensation, as if the stomach were empty and flaccid. ─ Swelling in the region of the stomach. ─ Pinching round the epigastrium and in the region of the hypochondria. ─ Pressure on the stomach with vomiting.

Abdomen

Cutting and pinching in the abdomen (as from a hand, each finger sharply pressing into intestines), < in the highest degree by movement, > by repose. ─ Pinching pain in both hypochondria, and in region of pit of stomach. ─ Pain, as from excoriation in the abdomen. ─ Colic, with agitation, tossing, and cries (in children). ─ Colic, with cramp-like pains. ─ Incisive pains, in the umbilical region, with shuddering. ─ Flatulent colic, with frequent diarrhœic stools. ─ Colic of strangulated hernia.

Stool and Anus

Loose evacuations, like matter in a state of fermentation (like yeast). ─ Obstinate diarrhœa. ─ Loose evacuations, greenish, or yellow- (lemon-) coloured, of a putrid smell, or sanguineous, bilious, and mucous. ─ Stools: grassy-green; of white mucus. ─ Loose serous evacuations. ─ Diarrhœa, with nausea, colic (and vomiting). ─ Autumnal diarrhœa; much griping about the navel. ─ Diarrhœa of children inclining to dysentery. ─ Dysenteric evacuations, with white flocks, and followed by tenesmus. ─ Evacuation of black matter like pitch. ─ Hæmorrhoids bleed profusely. ─ Itching of anus.

Urinary Organs

Turbid urine, with sediment like brick-dust. ─ Red and scanty urine. ─ Unsuccessful urging to urinate. ─ Sanguineous urine, with pains in the region of the bladder, and of the navel, burning sensation in the urethra, inclination to vomit, and pain in the loins and in the pit of the stomach. ─ Discharge of pus from the urethra, with biting pain.

Female Sexual Organs

Troublesome sensation, as of bearing down towards the genital parts, and towards the anus. ─ Menstruation too early and too profuse. ─ Metrorrhagia, with discharge of bright red and coagulated blood, with oppressed breathing. ─ Metrorrhagia, much depression and pain in r. half of head; soreness about womb and pain in l. hip and back; weight across forehead, and phlegm in back of throat, causing sickness; skin yellowish and very irritable, dark round eyes (cured). ─ Steady flow of bright red blood after confinement. ─ In labour and threatened miscarriage pains fly from l. to r., with nausea. ─ Catamenia premature, and too thick. ─ Stitches from navel to uterus.

Respiratory Organs

Cough, esp. at night, with painful shocks in the head and stomach, and with loathing, retching, and vomiting. ─ Cough catching the breath, even to suffocation; during the attacks the child gets quite stiff, its face blue. It is excited by a contractive tickling sensation extending from upper part of larynx to lowest part of bronchial tubes; < on walking in cold air; on retiring; in morning and evening; on taking a deep breath. Accompanied by cold, as if the navel would be torn out; pains in abdomen like strangury; heat in head and face. The cough causes vomiting without nausea. ─ Rattling noise in the bronchial tubes when drawing breath. ─ Dry cough, excited by a contractive tickling in the larynx (particularly in the upper part), extending to the extremity of the bronchia, esp. when lying on l. side. ─ Cough, which resembles whooping-cough, with bleeding from the nose and mouth, and vomiting of food. ─ Cough, with spitting of blood, provoked by the least effort. ─ Spasmodic cough, dry, shaking, with fits of suffocation, stiffness of the body, and bluish face. ─ Cough as from vapour of sulphur, with expectoration of blood with mucus in the morning. ─ Suffocative cough in the evening; continuous cough with perspiration on the forehead, shocks in the head, retching and vomiting. ─ Anxious and short respiration. ─ Quick, anxious breathing. ─ The breath smells fetid. ─ Suffocative attacks in the room; > in the open air. ─ Whooping-cough; every fresh attack sets in with a long-drawn, difficult, howling, sighing inspiration. ─ Spasmodic asthma, with contraction of the larynx, and panting respiration. ─ Sighing respiration.

Chest

Oppression of the chest, and shortness of breath, as if dust had been inhaled. ─ Loss of breath on the least movement. ─ Spasms in the chest. ─ Pain, as of excoriation in the chest. ─ Palpitation of the heart. ─ Red itching spots on the chest, with burning after scratching.

Neck and Back

Swelling and suppuration in the throat-pit. ─ Cramp pain between the scapulæ during motion. ─ Tetanic stiffness and bending of the back, backwards or forwards.

Upper Limbs

Coldness of one hand while the other is hot.

Lower Limbs

Convulsive startings of the legs and of the feet (not in the upper limbs). ─ Pain, as from dislocation, in the hip-joint, when sitting. ─ Nocturnal cramps in the muscles of the thigh, with lumps in the thighs. ─ Violent itching in the calves of the legs. ─ Ulcers, with black bases on the legs, and on the foot.

Generalities

Pain, as from a bruise, in all the bones. ─ Tingling in the joints, as when numbed. ─ Fits of uneasiness, with dislike to all food, and excessive and sudden debility. ─ Nausea, with almost all ailments. ─ Bleeding from different organs; hæmorrhages from all the orifices of the body (bright red). ─ Too great sensibility to cold and to heat. ─ Tetanus; spasms and convulsions of different kinds; sometimes with bending backwards of the head, and distortion of the features; or with loss of consciousness; face pale and bloated, eyes half closed, convulsive movements of the muscles of the face, lips, eyelids, and limbs, at times with cries, inclination to vomit, and rattling of mucus in the chest. ─ In morning, on awaking, anxious agitation of the blood, as if he had been subjected to a great heat, or had had profuse perspiration, or had awakened out of an anxious dream, though the skin was neither hot nor moist; at same time a heaviness in head as if brain were compressed. ─ Dropsy of internal parts. ─ Chlorosis, menses scanty; skin and mucous surfaces pale, anæmic. ─ Excessive emaciation.

Skin

Miliary eruptions, violent itching in the skin (of the thighs and of the arms). ─ During the nausea the patient is forced to scratch himself, until relieved by vomiting. ─ Rash (in lying-in women); suppressed rash.

Sleep

Sleeplessness. ─ Sleep, with the eyes half open. ─ Agitated sleep, with groans. ─ During sleep, starting of the limbs. ─ Frightful dreams, with frequent starts and terror during sleep.

Fever

Pulse very frequent, but at times scarcely perceptible. ─ Shuddering, with coldness in the limbs and in the face. ─ Chill of short duration and soon changing to heat. ─ Coldness, esp. in the hands and feet, with cold and copious perspiration on those parts. ─ External chilliness with internal heat. ─ Aggravation of the shivering from external heat. ─ Internal chilliness, as if under the skin, < from heat. ─ Before the shiverings, uneasiness, stretching, and lassitude, with cold sweat on the forehead, or coldness, or shivering, in the ears. ─ Sudden heat in a room, with sweat and vertigo. ─ Thirst during the shivering or coldness. ─ Fever, manifesting itself by much shivering, with little heat, or by much heat with little shivering; or with nausea, vomiting, and other gastric symptoms, tongue clean or loaded, and constrictive oppression of the chest. ─ Fever in the evening, with great inquietude, dry and troublesome heat, burning in the palms of the hands, and nocturnal sweat. ─ After a short chill dry heat, with parchment-like skin. ─ During the heat no thirst. ─ Perspiration smelling sour (with turbid urine). ─ Intermittent fever; nausea and vomiting predominate; slight chills are followed by much heat, with thirst and no subsequent perspiration, consequent upon the abuse of quinine; slight chilliness without thirst, afterwards violent heat, with thirst, nausea and vomiting, dyspnœa, stitches in the chest, finally copious perspiration. ─ Damp coldness of the hands and feet.

The Guiding Symptoms of Our Materia Medica

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

Mind

Is awkward and stumbles against everything.
Wrapt in thought ; taciturnity.
Full of inexpressible desires.
Moaning and sighing with the fever. θ Intermittent.
Child cries and screams violently and incessantly ; sticks fist into mouth ; face pale, body cool.
Every 6 or 8 weeks anorexia and hypochondria, with pressure and tension, and tympanitis of epigastrium ; constipation, with disgust and impatience of labor ; attacks preceded by nausea, and tendency to diarrhœa. θ Hypochondriasis.
Dejected mood, morose, enjoys nothing.
Peevish ; irritable ; impatient ; morose, scornful mood.
Ill humor, despises everything.
Fretfulness. θ Intermittent. θ Cholera infantum.
Extremely impatient.
Morose mood that scorns everything, and desires also that others shall not appreciate or value anything.
Ailments from vexation and reserved displeasure.

Sensorium

Apoplexia nervosa et serosa ; vertigo ; drooping of lips ; impaired speech ; dribbling of saliva from mouth ; paralysis of extremities.
Vertigo when walking and when turning.

Inner head

Lacerating pain in forehead, excited and aggravated by feeling the heart, or by stooping.
Aching in forehead ; fine stinging pains in forehead.
Headache over left eye.
Stitches in vertex, or forehead.
Lancinating in head.
Short paroxysms of fine and violently stinging pains in head, increasing to an aching.
Stinging headache, with heaviness of head, also with drowsiness.
Headache, as if bruised, all through bones of head and down into root of tongue ; nausea, vomiting ; > outdoors.
Headache as of a bruise of brain and skull, which pierces through all the cranial bones into roots of teeth, with nausea.
Headache as though brain were mashed, with nausea and vomiting ; miliary eruptions on forehead and cheeks by spells ; pale face, and pale mucous membranes ; scanty and short menses ; weak pulse, cold hands ; morose, enjoys nothing. θ Chlorosis.
Lacerating headache, from morning till noon.
Dull drawing in head, to and fro.
Beating pain in head and pit of stomach after coughing.
Heat and throbbing in head, with red cheeks.
Semilateral headache, with nausea and vomiting.
Tensive headache in occiput and nape of neck, extending as far as shoulders.
Pain in occiput and nape of neck.
Gastric headaches, occurring in nervous, sensitive persons, commencing with nausea and vomiting.
Malarial headache ; loss of appetite and vomiting.
Hydrocephaloid ; fontanelles open ; painful soreness of occiput and neck ; blue rings under eyes ; frequent nose-bleeding ; pale face ; nausea and vomiting ; green, putrid discharges from bowels.

Outer head

Cold sweat on forehead. θ Diarrhœa.
Open fontanelles ; occiput and neck sore. θ Hydrocephaloid.

Sight and eyes

Worse from light, especially of a candle.
Blue and red halo around light.
Optical illusions in bright colors.
Obscuration of sight ; eyes inflamed.
Eyes sunken ; blue margins around them. θ Cholera infantum.
Dilated pupils.
Severe shooting pains through eyeballs, profuse lachrymation on looking steadily ; blue and red halo around flame, pupil normal and mobile, with no external inflammation or lesion, except slight palpebral conjunctivitis. θ Choroiditis.
Phlyctenules and ulcers of cornea or conjunctiva, especially if there is much photophobia ; cornea may be vascular ; redness of conjunctiva, lachrymation and pain and nausea.
Pustular inflammation of cornea and conjunctiva.
Child after catching cold : lids red and swollen ; photophobia, lids being kept tightly closed ; copious, purulent discharge, < at night ; conjunctiva injected and swollen, especially on right side, where engorgement was so severe that pupil appeared buried in a
circular depression ; discharge from eyes so copious that it soiled hair and ears ; continual copious, green, diarrheic stools, with colic ; great emaciation ; sleepless day and night ; edges of lid red, without œdema ; right imbedded cornea ulcerated, also l.,
but in a less degree.
Inflammation of eyes ; on opening right lids, which were swollen, copious gush of tears ; conjunctiva of bulb injected and infiltrated, and on close examination number of small depressions were noticed ; intense tearing or tensive pains in eyes ; great photophobia.
Scrofulous ophthalmia when there is keratitis with ulceration or infiltration of cornea ; redness of eye, extreme photophobia, pain in temples and forehead.
Catarrhal conjunctivitis with profuse yellow discharge and chemosis.
Sclerotica yellow.
Hardened mucus in external canthi.
Twitching of eyelids.

Hearing and ears

Cannot endure the least noise.
Ears cold during febrile heat.

Smell and nose

Coryza : dry ; with stoppage of nose ; loss of smell ; nausea ; epistaxis.
Stoppage of nose ; loss of smell ; heaviness of head ; dry cough, particularly at night coming on in long lasting paroxysms, with painful shocks in head and stomach ; nausea followed by vomiting, general sweat and great weakness. θ Chronic
catarrh.
Nosebleed, blood bright red ; face pale.
Nose itches ; when nausea is over, violent hunger.

Upper face

Face : pale and puffed ; pale, and body cool ; sunken ; deathly pale, sunken eyes with blue margins ; livid, yellowish.
Convulsive twitches in muscles of face and lips.
Rash.

Lower face

Skin around the mouth red.
Smarting eruption and aphthæ on margin of lips.
Lips : blue, during chill ; white, during hemorrhage.

Teeth and gums

Child thrusts its fist into mouth ; screams violently ; face pale ; body cool ; vomiting and watery stools ; prostration ; spasms. θ Dentition.
Pain in a hollow tooth when biting on it.
Pain in molars > while eating ; < in afternoon and still more at night.
Teeth chatter, with chill. θ Intermittent.

Taste, speech, tongue

Loss of taste.
Taste : bitter ; sweetish, bloody ; like rancid oil, when swallowing ; earthy ; flat, with white, thickly coated tongue.
Tongue : clean ; yellow or white ; pale.
Disinclined to talk ; tongue dry.

Inner mouth

Profuse accumulation of saliva ; is constantly obliged to swallow it.
Smarting in mouth and on tongue.

Palate and throat

Fauces dry, sore, rough, stinging.
Spasmodic contractive sensation in throat and chest ; difficult deglutition.
Pressure in throat, with pains in diaphragm.
Deep red color of tonsils and pharynx.
Rapid congestion of mucous membrane of pharynx ; secretion of a thick, plastic, whitish, nauseous humor, appearing at first under form of small white or grayish points, either on tonsils or velum palati or pharynx.

Appetite, thirst. desires, aversions

Thirst or thirstlessness.
Desire for dainties and sweets.
Averse to all food, no appetite ; earthy taste ; stomach feels relaxed ; nausea.
Great disgust and loathing of any sort of food.

Eating and drinking

Indisposition from indigestible substances, lemon peel, berries, raisins, sweets, cake, pastry and unripe fruit, salads, pork, fats, sour beer, etc.
After eating : nausea ; vomiting ; stool.
Colic, with nausea and vomiting, after cold drinks or ice cream.

Hiccough, belching, nausea and vomiting

Hiccough : with nausea ; of children.
Eructations every eight to ten minutes ; with rumbling in abdomen.
Waterbrash.
Nausea : distressing ; constant, with almost all complaints ; as if from stomach ; with empty eructations ; accumulation of much saliva ; qualmishness, and efforts to vomit.
Nausea and retching from smoking ; primary effects of tobacco.
Faintness, nausea, retching. θ Post-partum hemorrhage.
Inclination to vomit without nausea.
Nausea, profuse saliva ; vomiting of white, glairy mucus ; < stooping.
Nausea, with distension of abdomen and dryness in throat ; after vomiting inclined to sleep.
Constant but unavailing desire to vomit ; or immediately after vomiting wishes to do so again.
Incessant retching with vomiting of watery fluids and cutting pain in belly.
Constant nausea and vomiting of yellowish mucus.
Vomiting : of ingesta ; of bile ; of grass green mucus ; bilious, putrid ; copiously of jelly-like mucus ; of blood, or of a pitch-like substance ; of a dark colored liquid, with or without blood ; of a sour fluid ; of large quantities of
mucus ; always with nausea ; during pregnancy ; with thirst, sweat, bad breath ; with diarrhœa, colic, distended abdomen ; with clean tongue.
Vomiting causes great pain in loins and hips.
Nervous vomiting, frequent and with constant nausea.
Vomiting due to irritability or other abnormal condition of nerves of stomach, particularly when tongue is clean, and persons are weak and nervous, and of large build ; constant nausea and retching of hysterical women ; morning vomiting in weakly persons who are affected by
worms ; nausea in nervous fevers and that which remains after an attack of indigestion.
Vomiting of food soon after eating, tasting very sour and accompanied by much retching ; tongue coated in middle, edges red ; region of stomach and hypochondria sensitive to pressure ; three or four stools daily ; general weakness ; menses irregular ; urine
dark, depositing urates.
Vomits everything taken ; food causes pain during short time it remains in stomach ; tongue brown and cleft ; bowels regular ; urine thick. θ Chronic vomiting.
Loss of appetite nine months ago, without assignable cause ; then followed vomiting of all food, with great debility ; bowels much relaxed ; smarting of eyes ; catamenia regular.
Vomiting almost constantly for days. θ Remittent fever.
Emaciated, scrofulous child, suffering from disease of mesenteric glands, vomited everything taken and cried the whole day ; the vomited matter and accompanying chopped stools smelt very sour.
Constant nausea often with vomiting large masses of mucus, generally green. θ Diarrhœa of children.
Tormina and bilious vomiting, coming on at first every fourth day, but latterly every Saturday ; nausea with extreme weakness and repeated fainting ; frequent attacks of violent, bilious vomiting, obliging her to keep in bed all day ; on other
days perfectly well.
Vomiting of infants at the breast.
Stooping causes vomiting.

Scrobiculum and stomach

Uncomfortable feeling in epigastrium.
Violent distress in pit of stomach ; attacks of pain ; beating.
Indescribable sick feeling in stomach.
Sensation as if stomach hung down relaxed.
Pressure in stomach ; clutching pains ; beating.
Cardialgia ; typical form.
Pain most severe in front of abdomen, extending to left hypochondrium, to sides, to back, and base of chest, with swelling of stomach ; great agitation ; constant nausea proceeding from stomach, with empty eructations and accumulation of much
saliva ; easy vomiting ; diarrhœa.
Stomachal catarrh, with abhorrence of all food, and tobacco ; with nausea, vomiting, colic and diarrhœa ; tongue always clean.
Gastric catarrh from indigestible food or ice cold things ; pain and mucous vomiting.
After eating fat pork, headache, loss of appetite, nausea, vomiting ; prostration and debility ; pain in forehead ; pale, bloated face ; photophobia without redness of eyes ; flat taste, slimy coated tongue ; great thirst ; frequent vomiting preceded by
pressure and pain in stomach ; frequent, offensive, flocky stools ; slight, dry cough ; occasional twitchings of muscles of face, lips and eyelids ; restless sleep with frequent startings.
Indigestion, from overloading stomach.
Dyspepsia every day, or every other day, at same hour.
After slight digestive disturbance, sudden vomiting of blood, occurring three times within seven days ; blood at first dark and coagulated, in subsequent attacks fluid and bright red, followed by bloody stools ; great prostration ; frequent fainting fits ; dimness of
sight ; slightest motion or cough causes nausea ; tongue brown, dry, like earth ; unquenchable thirst ; obstinate constipation.
After chagrin, constant pressing pain in pit of stomach, loss of appetite, frequent nausea ; eight days after this, in consequence of anger, sudden vomiting, first of clotted, then of fluid blood, amounting to about two pounds ; deathly pale ; almost pulseless ;
faintness.
Acute distress in epigastric region ; forcibly vomiting immense quantities of black, tar-like matter, gushing from nostrils as well as mouth ; extremities cold ; hippocratic countenance ; pulse almost imperceptible ; cold, clammy sweats ; extreme prostration
and exhaustion. θ Melena.
After long continued, pressing pain in stomach, which alternated with toothache, sudden vomiting of blood, with great faintness ; blood dark, thin, about one pound in quantity ; pulse full ; a second attack with great faintness, anxiety, feeble pulse, pale, cold
face and cold hands.
Pale, anemic girl, subject to pains in stomach and irritable conditions of mind, was suddenly seized with vomiting of blood after indulging in strong coffee ; blood at first brownish black, then black and half coagulated, escaping in great quantities ;
between each attack of vomiting, which occurs about every half hour, anxiety, pressure in stomach, fainting ; pulse small and feeble ; face and hands pale and cold ; thirst and internal heat.
After exposure to cold and wet, rigors and dyspnœa, followed by copious spitting of blood ; cannot speak ; sits on a chair, gasping, and every few seconds brings up a large mouthful of bright colored, frothy blood ; pulse small and frequent ; respirations short and
very frequent ; face livid and expressive of anxiety. θ Hæmoptysis.
Sudden attack ; blood dark, black, sour ; paleness ; coldness ; pulse scarcely perceptible ; fainting ; anxiety ; pressure in stomach ; great thirst ; oppression of breathing. θ Hematemesis.
Hematemesis of children.

Hypochondria

Pinching pain in both hypochondria and in region of pit of stomach.
Pain in left hypochondrium.
Diaphragm feels as if pressed between two millstones, front to back.

Abdomen and loins

Distressing feeling in abdomen, as though stomach were hanging down, relaxed.
Sore feeling in abdomen.
Griping, as from a hand, each finger sharply pressing into intestines ; > during rest, much < by motion.
Clutching and squeezing in abdomen.
Flatulent colic about navel, as though bowels were grasped with hand. θ Dysenteric diarrhœa.
Cutting colic near umbilicus ; sometimes shivering.
Tenderness and pain about umbilicus, towards uterus.
Stitches from navel to uterus.
Cutting pain almost constantly running from left to right with every movement.
Paroxysms of shooting across abdomen from left to right, causing nausea and vomiting, vomits froth and bile with difficulty ; when vomiting, coughs to bring it up ; sweats ; offensive black stools ; vomiting causes great pain in loins and hips, as if all the bones in
body were being torn to pieces.
Severe pains in abdomen, radiating to all sides.
Flatulent colic, with frequent loose stools.
Colic of children : with diarrhœa, uneasiness, screaming and tossing about ; from indigestion ; after acid or unripe fruit, beer, etc.
Inguinal hernia, readily reducible, or strangulated.

Stools and rectum

Stool : bloody ; as if fermented ; consistence and appearance of fermented yeast ; spurting out with much flatus ; very offensive ; light yellow ; lemon colored ; green as grass ; greenish mucus ; lumpy, greenish watery ;
white mucous, bloody ; yellow, liquid, covered with bloody mucus ; pitch-like or like frothy molasses ; slimy, bloody, offensive, followed by tenesmus ; putrid smelling ; containing blood and matter.
Diarrhœa of teething children, yellow, white or green discharges, no pain or emaciation, but serious because of its long continuance ; particularly indicated at period of weaning when food disagrees.
Diarrhœa : with pain, causing unceasing screaming and tossing about, in children ; from taking cold ; from disordered stomach, after late suppers ; of infants, with vomiting of green or whitish matter ; due to chill or to mental emotions ; after overloading
stomach with sweets, or fat pastry ; in the Autumn.
Summer complaint of children, with crying, tossing, large abdomen, frequent, small, yellow, fermented stools.
Colliquative diarrhœa of dark colored stools, or of greenish matter, with particles having appearance of coagula.
Chronic diarrhœa, of miasmatic origin ; clean tongue and frequent nausea, constant pain at umbilicus.
Acute internal catarrh.
Epidemic dysentery, with nausea, vomiting, pain in epigastrium, pressive frontal headache, loaded tongue, tenesmus, mucous fetid diarrhœa, < at night.
Dysentery : stools frequent, slightly tinged with blood, and often entirely composed of blood and slime ; in the Fall, with vomiting of bile, tenesmus after stool and simultaneous affection of celiacus ; stools almost black, and fermented like frothy molasses ; of
children ; cold nights after hot days.
Cholera infantum : nausea, vomiting, colic, diarrhœa ; especially in fat, pale children ; nausea and vomiting of yellowish mucus ; lumpy, greenish, watery stools ; paleness of face ; blue margins around eyes ; wants to lie down, ill humor ;
copious, fermented, flatulent, lemon colored stools, with thirst, fever and fretfulness.
Stools light green or an arsenic green.
First symptoms of cholera Asiatica ; the nausea and vomiting predominates, headache and tightness of chest.
Vomiting after all ingesta, and as often as every quarter of hour, without cause ; vomiting copious, preceded by shivering all over ; no coldness or cramps ; pulse slow ; tongue furred. θ Cholera.
Before stool : colic, nausea, vomiting.
During stool : colic, nausea, vomiting ; violent tenesmus ; lassitude, coldness, paleness of face.
After stool : lassitude ; tenesmus ; twitching of face.
Hemorrhoids bleeding very profusely.
Itching at anus.

Urinary organs

Urine : scanty, dark red ; turbid, with red sediment.
Yellowish red sediment in urine. θ Quotidian ague.
Unsuccessful urging to urinate.
Ischuria, with convulsions.
Hæmaturia : with cutting in abdomen and urethra ; from suppressed itch ; with vesical spasm.
After becoming chilled, felt ill all over ; very weak, could hardly move about from vertigo ; confused ideas ; severe pain in kidneys, with heat in lower bowels as if hot water was poured into them ; towards evening violent pain in abdominal region and bladder, with
desire to urinate, with passage of scalding urine and blood, fluid and clotted ; next day, too weak to stand ; feet quite cold, and as if paralyzed ; head stupefied, could not sit up ; more blood, followed by swoon, with deadly pallor, hardly, perceptible pulse, and cold
extremities ; could hardly speak ; heaviness of head, uneasiness and inclination to vomit, pressure on pit of stomach, pain in lower bowels and kidneys, weight and coldness of feet ; frequent micturition. θ Hæmaturia.
During urination : burning in urethra ; pains in back and epigastrium.

Female sexual organs

Prolapsus and hemorrhage ; profuse, clotted blood, with heavy, oppressed breathing ; constant flow of bright red blood, with cutting about umbilicus ; constant nausea and vomiting ; feels cold and is very pale ; dizziness and
headache ; chill and coldness of body while internal heat rises up into head, with a bearing down pressure to uterus and anus ; fainting ; blood spitting, hematemesis ; faintness with convulsions.
Great debility and leucorrhœa during intervals of menses.
Continual discharge of bright red blood.
Profuse menstruation, with constant nausea, not a moment's relief, not even after vomiting ; nausea proceeds from stomach, and the discharge of bright red blood is increased with every effort to vomit, and flows with a gush ; violent pressure over uterus and rectum,
with shuddering and chilliness ; heat about head and debility ; gasping for breath, faintness ; after childbirth, after removal of placenta or after miscarriage ; < when getting out of bed. θ Uterine
hemorrhage.
Menses appeared four times in seven weeks, and last time so seriously that blood passed in large clots, and such a quantity of black fluid that it brought on swooning, loss of consciousness ; vomiting of mucus, with cold skin looking like wax, blue lips,
small, scarcely perceptible pulse. θ Congestive menorrhagia.
Menses : too early and too profuse ; blood bright red ; menses return every two weeks ; great weakness after menses ; peevish humor ; aching in head ; lancinating in forehead ; pale face ; blue rings around eyes ; vomiting of
ingesta ; distress in umbilical region.
Profuse menstruation, with constant nausea ; not a moment's relief, not even after vomiting.
Discharge of blood before the proper period.
Scanty or short menses.
Dysmenorrhœa.
Severe pain about umbilicus, extending towards uterus, most distress about navel, but it runs off into uterus.
With every movement a cutting pain, almost constantly running from left to right.
Uterine pains running down.
Pain extending towards and passing off into uterus.

Pregnancy. parturition. lactation

Vomiting of pregnancy ; in some cases more nausea than vomiting.
Vertigo in pregnancy, with pale, bluish, puffed face, blue lips and nails ; undulation of jugular veins.
Threatened abortion, often with a sharp or pinching pain around umbilicus, which runs downward to uterus, with constant nausea and discharge of bright red blood ; convulsions.
In sixth week of pregnancy seized suddenly with abdominal pains, heat in epigastrium and vertigo ; flooding soon followed by shooting in kidneys, weakness and heaviness of thighs and general debility ; flooding increased hourly, soon passing through mattress, and flowing in
abundance under bed ; colic increased, face pale and eyes encircled with blue ; miscarriage followed, accompanied by acute pain ; hemorrhage became more serious ; pains in heart followed by dryness of mouth and great thirst ; great exhaustion, could hardly speak.
After abortion occasional slight loss of blood, for four months, when an alarming hemorrhage took place with the usual symptoms, besides vomiting after least drink.
Incessant flooding ; complete prostration ; breathing heavy ; oppression ; colorless face and lips ; ringing in ears ; faint on raising head from pillow ; flow bright red ; much persistent nausea ; pain in umbilical region, running down to
uterus.
During labor pains great hemorrhage, apparently from placenta.
Labor pains spasmodic ; cutting across from left to right ; nausea ; clutching about navel.
Uterine pains accompanied by severe cutting pains in umbilical region, interfering with true pains ; faintness and nausea.
Uterine pains running downward.
Stitches darting off from umbilicus towards uterus.
After removal of placenta, sudden and alarming distension of abdomen in region of atonic uterus ; face and tongue pale ; sighing respiration ; faintness, nausea, retching ; cutting pains about umbilicus. θ Post-partum
hemorrhage.
Arterial bleeding from partial separation of placenta.
Post-partum hemorrhage ; placenta attached ; hemorrhage frightful, very fluid and gushing.
Metrorrhagia, often after confinement, heralded by slow pulse, nausea, etc. ; steady flow of bright, red blood.
Nausea and vomiting in nursing women.

Voice and larynx. trachea and bronchia

Voice hollow.
Spasm of cords ; constant, alternate contraction and relaxation of cords, following each other in rapid succession.
Contraction accompanied by a sensation of tickling at entrance of trachea.
Spasm of glottis ; blueness of face and coldness of extremities.
Inflammation of fossa ; very little œdema. θ Laryngitis.
Rattling in bronchi, when drawing a long breath ; large accumulation of mucus in bronchi, difficult to raise.
Rattling noises in air passages during respiration.
Suffocative attacks from foreign substances in windpipe.
Bronchitis, with loud mucous rales ; difficult expectoration ; cough with nausea, even vomiting, or oppression, > by abundant expectoration.

Respiration

Oppression of chest in forenoon, with shortness of breath, as from inhaling dust.
Breathing : anxious and hurried ; short and hurried ; short and panting ; heavy.
Rattling noise in bronchi when drawing breath.
Breath fetid, with vomiting and sweat.
Difficulty of breathing from least exercise.
Pain in diaphragm takes away breath.
Violent degree of dyspnœa, with wheezing, and great weight and anxiety about precordia.
Attacks of suffocation ; > in open air ; < from least motion ; constriction in throat and chest.
Threatened suffocation from accumulation of mucus.
Cough impedes respiration, even to suffocation.
Loses breath with the cough, turns pale in face and stiffens. θ Whooping cough.
Suffocative cough with dyspnœa, nausea vomituritio, at end of attack. θ Whooping cough.
Urgent dyspnœa, with sense of constriction across chest, accompanied by violent and convulsive cough.
Dry, spasmodic, shattering cough ; during attack arrest of breathing, patient falling senseless to floor ; each attack threatens to end fatally, and can only be overcome by use of cold water.
Difficult expiration.
Severe and convulsive paroxysm of asthma.
Violent constriction of throat and chest, peculiar, panting sound ; gasps for air at open window ; face pale ; scarcely perceptible pulse ; < from least motion ; threatened suffocation. θ Asthma.
Spasmodic asthma : with great constriction in throat and chest ; with peculiar wheezing noise ; with danger of suffocation ; with bronchial catarrh ; of adults ; in hysterical subjects ; after suppressed miliary eruptions.
Asthma, cyanosis supervening during fit, with frequent dry cough, cold sweat on face and extremities, constitutional vomiturition, nausea or even vomiting after cough.
Nightly suffocative fits. θ Asthma.
Asthma Millari, with tickling in larynx, retching and vomiting.
Asthma of emphysematous subjects, when auscultation detects considerable quantity of mucus accumulated in bronchi, which patient cannot by any effort throw up in sufficient quantity ; coughing brings on nausea.

Cough

Dry cough, caused by tickling in upper part of larynx.
Cough caused by a constrictive tickling from upper portion of larynx to lowest extremity of bronchi.
Cough dry, spasmodic, capricious, provoked by tickling and irritation of larynx, after coryza, at first dry, then fluent.
Spasmodic or catarrhal titillating cough, or suffocating cough with dyspnœa, nausea, vomiturition, especially at end of paroxysm, or with expectoration of scanty, albuminous, nauseous mucus ; mucous rales and vomiting of food.
Violent spasmodic cough, cannot cough soon enough at first ; covers mouth with hand, in order not to inhale too much air.
Frequent attacks of spasmodic cough, shaking, racking, hollow ; quickly following coughs from tickling in upper part of larynx, as from vapor of sulphur ; expectoration of blood and mucus in morning.
Spasmodic cough with tendency to vomit, or with vomiting of whitish mucus ; mucosity is easily produced in chest, and cough produces sonorous and bubbling rales.
Dry, spasmodic cough without vascular excitement.
Dry, spasmodic cough of old persons, coming on in fits, particularly at night after going to bed, or after dinner ; tends to emphysema.
Cough with pain in abdomen, especially about navel, or pressure on bladder, hindering passage of urine ; beating in head, or in pit of stomach ; sense of excoriation in chest ; after paroxysm of coughing respiration continues short, and forehead streams with
perspiration ; < in open air.
Cough coming on after a meal, especially P. M. ; cough excited by each inspiration ; tickling and constriction of upper part of trachea, coming on in open air ; sudden precipitate fit of coughing ; failure of breath ; danger of asphyxia from mucus ; anguish
from choking ; eyes starting out of head ; face bluish red ; buccal and nasal hemorrhage ; efforts at vomiting ; fit ending with vomiting of food ; swooning during fit. θ Influenza.
Suffocative, racking, very exhausting cough, lasting an hour, towards evening.
Suffocating cough, whereby child becomes quite stiff and blue in face.
Loses breath with cough, turns pale in face, and stiffens.
Suffocative evening cough ; continuous cough, with sweat on forehead, shocks in head, retching and vomiting.
Strangling with cough till blue in face. θ Pertussis.
Incessant and most violent cough with every breath.
Cough causing inclination to vomit without nausea.
Cough, with retching, much mucous expectoration and considerable dyspnœa.
Cough causes gagging, vomiting is followed by relief.
Cough with expectoration of blood.
Convulsive evening cough, expectoration having a repulsive metallic taste.
Cough especially at night, with loathing and vomiting.
Croupy coughs occurring at night.
Cough : nervous, spasmodic ; rough, shaking ; dry, from titillation in upper part of larynx ; with every breath ; returning after exertion ; < from cool air ; with inclination to vomit ; with spitting of blood from least effort ; constant,
no phlegm yields, though chest seems full ; strangling, so much mucus seems accumulated in bronchia ; croupy, at night ; fat children ; in hysterical women ; in teething children.
During cough : headache ; sore pain in chest ; paroxysms of suffocation, with rigidity of body ; painful concussions (shocks) in stomach and head ; pains in epigastrium and umbilical region ; bleeding from mouth and nose ; nausea, retching,
vomiting ; perspiration of forehead ; blueness of face ; jarring of body ; loss of consciousness and falling down.
Spasm of glottis before paroxysm ; bleeding from nose and mouth during coughing fits ; vomiting of mucus or food ; convulsions and stiffening of body backwards ; vomiting of food without coughing ; rattling of mucus in bronchial
tubes ; rash, eruption. θ Whooping cough.
Convulsion of glottis continuing so long that child remains for a time without respiring ; cough dry, vomiting after the fit without expelling much mucus ; dyspnœa ; fine rales in back at lower part of thorax. θ Whooping
cough.
Violent, shattering, hollow coughs, following each other in quick succession, and do not admit recovery of breath ; expectorates mornings some light red blood, mixed with mucus, of a putrid, sweetish taste. θ Tussis
convulsiva.
Whooping cough : with nosebleed ; bleeding from mouth ; vomiting ; loses breath, turns pale or blue, and becomes rigid.
Febrile cough (principally after Pulsat. and Nux vom.), in women and children ; irregular periods of heat, during which the dry cough gets worse.
Tussis abdominalis, with vomiting which relieves.
Phlegm rattling on chest, sometimes vomited, with young children.
Expectoration of mucus with metallic taste.
Sputa scanty, albuminous.
Expectoration : mornings, of a light red blood, mixed with mucus, or of ropy mucus, often vomited ; of blood from least effort.

Inner chest and lungs

Spasmodic tightness of chest, with contraction of throat and panting breathing.
Great oppression of chest, can hardly breathe. θ Intermittent fever.
Acute catarrh of children ; suffocating cough, with congested and bluish face, and loss of breath, or when cough is accompanied by nausea and vomiting, or provoked by a tickling in larynx, with throbbing of head and heart and longing to pass water.
Rattling of large bubbles ; fever, but face rather pale ; cough and gagging.
Collection of mucus which is difficult to expectorate ; expectoration gives but temporary relief.
Strangling as if from mucus in chest.
Bronchitis : of children ; with accumulation of phlegm, which threatens to suffocate ; spasmodic cough ; rash on chest.
Fine, rattling noises in chest, spasmodic cough ; nausea ; œdema pulmonum.
Pulmonary congestion and simple pneumonia, consequent upon repercussion of scarlatinal eruption.
Infantile pneumonia ; respiration rapid, difficult ; surface blue ; face pale.
Profuse hemorrhage, of a bright red color, provoked by a dry, tickling, racking cough, or even by a little hawking, < from least exertion ; preceded by a sense of bubbling in chest and accompanied by nausea, chills, heavy breathing, oppression, livid face, small and frequent
pulse, anxiety and debility ; cannot utter a word ; protracted taste of blood in mouth.
Hemorrhage from lungs after venesection, especially if bleeding is scanty, constituting an expectoration of blood streaked mucus ; or a blood spitting, from least effort, without cough.
Blood frothy and bright colored ; gasping for breath pulse small and frequent ; face livid and anxious.
Hemorrhage from lungs : bright red ; coming up with slight effort ; < from least exertion ; frequent hacking, with expectoration of blood streaked mucus ; with or without cough ; after disturbed catamenia ; after
mechanical injuries ; after former bleedings have weakened lungs ; with dry cough in phthisis.
Hæmoptysis ; recent cases.
Vomiting and complication of asthma in emphysematous subjects. θ Influenza.
Cyanotic symptoms with spasms of chest and dyspnœa.
Spasmodic affections of chest.
Shooting pain with remissions, not inflammatory, cannot breathe, puts both hands down, bends forward, opens windows, gasps for breath ; attacks < at night.
Emphysema of old people.

Heart, pulse and circulation

Pulse : large and soft ; accelerated but weak ; sometimes imperceptible.

Neck and back

Swelling and suppuration in throat pit.
Cramp between scapulæ during motion.
Much pain in back, at same time in limbs.
Shooting pains, from right kidney down thigh to knee, like cramp.

Upper limbs

Coldness of one hand, while the other is hot.
Cold hands.

Lower limbs

Sensation in femur, as if dislocated, on sitting down.
Cramps in thighs, at night, with lumps in thighs.
Convulsive twitchings of legs and feet. θ Hemorrhage.
Itching of calves.
Ulcer with black base on foot.

Limbs in general

Sensation as if joints had gone to sleep.
Pain in joints, as is usual when limb goes to sleep.
Pain, as if bruised, in all the bones.
Cold hands and feet.

Rest. position. motion

Rest : griping in intestines >.
Restless, tosses about from side to side.
Hands clenched and arms thrown violently forward.
Puts both hands down, bends forward : on account of shooting pain in chest.
Sitting down : sensation in femur as if dislocated.
Sits on a chair gasping : after blood spitting.
Could not sit up : after pain in abdomen.
Falling down : during cough, with unconsciousness.
Wants to lie down : cholera infantum.
Lies upon back unconscious : during spasms.
Head thrown back : during spasms.
Body bent backwards : during hysterical spasm.
Body rigid, stretched out, jerking of arms.
Body violently bent backwards and drawn in same direction by spasmodic jerks.
Slightest motion causes : nausea, cutting pain in abdomen ; attacks of suffocation ; constriction of throat < ; cutting pain from left to right through uterus.
Motion : griping in intestines < ; sweat < ; cramp between scapulæ ; sweat <.
Least effort : difficulty of breathing ; spitting of blood ; profuse hemorrhage.
Exertion : cough returns.
On raising head from pillow : faintness.
Getting out of bed : vertigo and weakness of knees ; menstruation <.
Tossing about : from diarrhœa.
Tossing up body : during spasm.

Nerves

Oversensitive to heat or cold.
Restlessness with the fever. θ Intermittent.
Very weak, averse to all food ; nausea ; sudden prostration.
Extreme prostration and exhaustion ; seemingly the last straits of vitality are reached. θ Melena.
Wants to lie down. θ Cholera infantum.
Awkward, stumbles against everything.
Fainting ; convulsions ; apoplectic sopor.
Hysterical spasms, coming on several times a day, and gradually growing more severe ; body bent backwards ; muscles of face distorted ; groaning.
Hysteria ; every fresh development of hysterical symptoms brings on a sensation of continual nausea.
Nervous attacks with feeling of suffocation.
Convulsive twitching in limbs, a painful tremor.
Spasms without loss of consciousness.
Tetanic rigidity of body with bluish redness of face.
Body rigid, stretched out, spasmodic jerking of arms.
Body violently bent backwards and drawn in same direction by spasmodic jerks. θ Tetanus.
Spasms after catching cold during purpura ; lies upon back unconscious ; face pale and swollen ; eyes at one time closed, again open ; horrible twitching of muscles of face, lips and eyelids ; spasms of arms and legs often tossing up the body ; attacks come
on every five minutes, lasting ten to fifteen minutes, and are followed by great prostration ; occasional retching.
Clonic or tonic spasms in children and hysterical women ; head thrown back ; loss of consciousness ; outcries ; pale, puffed face ; distortion of muscles of face and of half closed eyes ; convulsive twitchings of muscles of face, lips, eyelids and
limbs ; asthma ; nausea ; vomiting.
Awoke from sleep in evening with wide open, staring eyes ; hands clenched and arms thrown violently forward ; lies quiet several minutes, then gasps and groans ; constant staring with spasmodic contraction of right arm ; eleven attacks in twenty-four hours.
Frightful spasms affecting while of left side, followed by paralysis ; eyes fixed and turned to right ; pupils dilated and insensible ; frequent opening and shutting of lids ; slight contractions of right corner of mouth ; at times regular movements of right arm
and hand ; pulse frequent and feeble ; tracheal rale, as in paralysis of lungs ; discharge of brown mucus from mouth ; respiration irregular ; inspiration short, followed by slow, sighing expiration ; skin hot, but right ear cold. θ Eclampsia.
Eclampsia in pregnancy or childbed ; violent cutting around navel ; vomiting ; pale face.
Fainting, summer heat or hot rooms, with nausea.
Convulsions : in whooping cough ; from suppressed exanthema ; from indigestible food, etc.
Tetanic spasms from swallowing tobacco.
Tetanic spasms in old lady, with starting, twitching ; coughs up bloody phlegm.
Tetanus ; trismus.
Opisthotonos and emprosthotonos.
Catalepsy.
Epileptiform spasms, with shrieks ; opisthotonos ; face pale, puffed ; gastric derangement.
Epilepsy of children or secondary epilepsy, when its starting point is the pneumogastric nerve.

Sleep

Yawning and stretching.
Shocks on falling asleep.
Sleep, with half open eyes ; moaning, groaning.
Starts up in sleep.
Sleepless.
When deprived of sleep : nausea and languor.

Time

Morning : vomiting ; expectoration of blood and mucus ; expectorates light red blood with mucus ; paroxysms of chill lasting half an hour, heat lasting two hours ; bitter taste in mouth.
From morning till noon : lacerating headache.
At 9 A. M. : chill.
At 11 A. M. : chill.
Forenoon : oppression of chest.
Day : sleepless.
All day : cried continually ; obliged to keep in bed on account of bilious vomiting.
Afternoon : pain in molars < ; severe chill ; yawning with chilliness.
Till 2 P. M. : nausea and vomiting.
At 3 P. M. : severe chill lasting one hour.
Towards evening : lasting one hour, suffocative, racking, very exhaustive cough ; violent pain in abdominal region and bladder.
Evening : suffocative cough ; anxious, dry heat ; sensation of great weakness ; awoke from sleep with wide open, staring eyes ; general heat ; dry heat very troublesome.
Lasts till 7 P. M. : fever.
Night : discharge from eyes < ; sleepless ; dry cough < ; pain in molars < ; dry, spasmodic cough ; croupy cough ; attacks of shooting in chest < ; very profuse sour sweat ; disagreeable heat ; epidemic dysentery < ; cramp in thighs ;
irritable, irascible ; fever <.

Temperature and weather

Oversensitive to heat and cold.
Worse in winter and in dry weather.
Worse in warm, moist wind, south winds ; catarrhs ; asthma, etc.
Warm room : chill <.
Summer heat or hot room : fainting.
External heat : < chill.
Oversensitiveness to heat or cold.
Out of doors : headache > ; sweat <.
Open air : suffocation > ; cough < ; cough comes ; chill < ; chill >.
Covers mouth with hand not to inhale too much air.
Gasps for air at open window : constriction of throat.
Cool air : nervous cough <.
After exposure to cold and rain : hemorrhages <.
After exposure to cold and wet : rigors and dyspnœa, then spitting of blood.
After catching cold : lids red and swollen.
Drinking : chill >.
After cold drink or ice cream : colic.
Cold water : > spasmodic cough.

Fever

Paroxysm begins with an internal chill, made < by external heat.
Chilliness, cold hands and feet, which are moist or dripping with cold sweat.
Coldness of upper part of body.
Chill but slight with many gastric ailments.
Chill : preceded by violent retching ; mostly with thirst but also without ; with great oppression of chest ; with nausea and vomiting ; with diarrheic stools ; < in a warm room or from external heat ; > by drinking, and in open air ; at 9 A.
M. ; every other day at 11 A. M. ; of short duration soon changing to heat ; with great lassitude and weariness.
After a short chill, dry heat, with parchment-like skin.
Severe chill in afternoon with nausea, followed by heat with sweat of several hours' duration, and ending with sour sweat ; during apyrexia, coated tongue ; pressure at stomach. θ Quartan
ague.
Great nausea before chill and during whole paroxysm, cannot stir eyes without nausea, but no vomiting ; great thirst during chill, none during fever or sweat ; very nervous, trembling, during chill shook inside ; intense headache during paroxysm, and in a modified degree
during apyrexia, extending down to root of nose and throat ; sweat like rain ; paroxysms irregular. θ Ague.
Chill irregular, light and short ; fever long, but not very violent ; no thirst during chill, but much thirst all through heat ; thick, white, pappy coating on tongue ; complete loss of appetite ; great weakness and prostration during apyrexia ; constant
nausea and occasional vomiting.
Chill from 9 A. M. to 3 P. M., with intense aching in back and bones ; nausea and vomiting after chill ; intense fever with thirst and throbbing frontal headache ; becomes unconscious during fever, which lasts till 8 P. M., when sweat comes on for about one hour, together
with great shaking all over, and great thirst ; continued jumping headache, very thirsty all the time with anorexia. θ Ague.
In afternoon yawning with chilliness, extending from back, soon followed by coldness of extremities, internal shaking, trembling and cramps in chest ; in evening, general heat accompanied by great impatience and despondency ; great heat, particularly in head and face, cheeks
red, pulse soft, small, slightly increased ; pain in limbs as if they were broken ; heat followed by sweat ; no thirst during fever ; loss of appetite ; escape of saliva from mouth during sleep ; next day lassitude, headache, flat taste, several diarrheic
stools, with cutting pains in abdomen. θ Ague.
Paroxysm at 10 A. M.
Aching in bones and pain through temples, with heaviness in forehead ; chills up and down back, with great thirst, lasting fifteen minutes, was not a "regular shake," accompanied by great languor and weakness, so that "he fell down in a
bunch", then came nausea and vomiting, followed by a burning fever, which lasted until 2 P. M. ; thirst and throbbing headache during fever, followed by profuse sour sweat ; paroxysms postponing. θ Ague.
Chill at 9 A. M. ; teeth chatter ; nails and lips blue ; no thirst ; next fever, slight thirst, moaning, sighing ; slight heat ; restlessness ; pulse large and soft ; tongue coated white and thick ; frontal headache ; diarrhœa, stools
yellow and painless ; internal heat, with external coldness ; drinks little ; much nausea and vomiting ; albuginea yellow ; perspiration stains linen yellow.
External coldness with internal heat.
Sudden attacks of general heat, with cold hands and feet.
One hand cold, the other hot.
Hands and feet icy cold and bathed in cold sweat, with redness of one cheek and paleness of the other.
Heat all over, with alternate coldness and paleness of face ; cold sweat on forehead.
Heat with nausea and vomiting ; anxious, oppressed breathing ; dry, hacking cough, often exciting nausea and vomiting.
Anxious dry heat in evening.
Heat, with or without thirst.
Sweat : hot, sudden attacks in room ; partial, cold ; on upper part of body ; < by motion ; pungent, sour smelling ; stains yellow ; < out of doors ; cold, clammy.
Sour sweat with turbid urine.
Very profuse sour sweat, mostly during night.
Profuse sweat after abuse of quinine.
Paroxysm sets in with yawning, stretching, and a collection of saliva in mouth ; chill generally of short duration, soon passing over into heat ; internal chill, as if under skin, < by hot applications, > by drinking and in open air ; no thirst or but little during
chill ; violent thirst for large quantities during heat. θ Intermittent.
In evening sensation of great weakness ; restless, tosses about from side to side ; slowly opens eyes and then closes them again ; speaks in a low voice of things which have occurred previous day ; spasmodic stretching and yawning ; cold feet ; paroxysm
lasts one to two hours followed by sleep, after which patient is not aware of having had attacks. θ Quotidian ague.
Paroxysms occur in morning and consist of moderate chill lasting about half an hour, followed by scarcely perceptible dry heat, lasting about two hours, during which pulse is full, soft and moderately frequent ; with chill severe raging headache, brings tears to patient's
eyes ; nausea, pain in stomach, and short dry cough ; headache continues until evening ; during apyrexia, vertigo, loss of appetite, pain in small of back and limbs. θ Quotidian
ague.
Shivering, with gooseflesh, followed by flying heat, both of short duration ; loss of appetite ; tongue white ; stool scanty and hard ; heat in stomach and sensation of hunger ; bitter taste in mouth in morning ; waterbrash and retching ; red, itching
spot on right chest, burning after scratching. θ Quotidian ague.
Severe chill 3 P. M. without thirst, lasting one hour, followed by heat with stupefying headache and great thirst ; sweat long and profuse with thirst ; during apyrexia great weakness and lassitude ; on getting out of bed vertigo and weakness of knees ; disagreeable
heat at night ; restless, unrefreshing sleep ; anorexia ; bitter taste ; white tongue ; thirstlessness. θ Quotidian ague.
Tertian ague anteponing half hour ; chill one and a half hours' duration ; high fever with sweat, lasting rest of day ; during whole attack great thirst, water taken being soon vomited ; headache with the fever ; during apyrexia, earthy taste, pressure in
stomach, debility.
Chilliness with yawning and vomiting ; after an hour heat in head and redness of face, hands and feet being scarcely warm, followed by sweat on face ; during apyrexia despondent, will not play, lies about a good deal, loss of appetite, grayish yellow diarrhœa, scanty red
urine, restless sleep. θ Tertian ague.
Hard chill every other day, at 1 or 2 P. M. ; continual nausea and vomiting of bitter, bilious matter, and of everything taken into stomach ; chill very violent, with great thirst, and drinking only a little at a time ; towards the last has chills and flushes of heat, then
great heat and profuse sweat.
Chill every other day, at about 11 A. M. ; shivers awhile, then shakes for twenty minutes ; headache ; hands first cold ; nausea all the time ; no thirst with the chill, but with the heat ; chill followed by fever ; sweat after fever. θ Intermittent.
Backache, short chill, long fever ; heat, usually with thirst, headache, nausea and cough.
Recent cases, occurring in young, previously healthy persons ; paroxysms violent and regular, generally of tertian type. θ Ague.
Predominance of gastric symptoms during paroxysm as well as during apyrexia. θ Intermittent.
Relapses from improprieties in diet.
Paroxysms suppressed by quinine.
Intermittent fevers after abuse of quinine ; also in beginning of irregular cases, especially if there is much nausea.
Worse during sweat ; better after it.
Type : quotidian ; tertian ; quartan ; apt to postpone and become irregular.
Prodroma : nausea ; violent retching ; yawning, stretching, backache, headache, and profuse flow of saliva.
Apyrexia : never clear ; disturbed by gastric troubles ; pale face ; herpes labialis ; anorexia ; taste of insipid water, salivation ; sense of emptiness and weakness of stomach, nausea ; loose stools ; bruised feeling of limbs ; restless
sleep ; difficulty in collecting one's thoughts ; sadness.
Infantile remittent fever.
Yellow coating on tongue, with dry mouth ; loathing of food, with desire to vomit ; fetid odor from mouth ; bitter taste in mouth, and of food ; nausea, with regurgitation of ingesta, and vomiting of undigested food ; pressure and painful fulness in pit of
stomach ; colic ; diarrheic, yellowish stools, or fetid, putrid stools ; pale, yellowish color of skin ; headache, especially in forehead ; febrile heat, with thirst or shivering. θ Bilious
fever.
Yellow fever, in first stage ; dizziness, chilliness, pain in back and limbs, uncomfortable feeling in epigastrium, with nausea, vomiting and great weakness.
Dry and extremely troublesome heat, especially in evening, with thirst ; great restlessness, burning in palms of hands and night sweats ; parchment-like skin ; desire for dainties only ; very listless. θ Hectic
fever.
Worm fever, with retching, blue rings around eyes, vomiting with a clean tongue.

Attacks, periodicity

Attacks of illness, with loathing of food.
Paroxysms : of abdominal pains ; of great weakness, last one to two hours ; of suffocation ; intermittent.
Fits : of dry, spasmodic coughing.
Following each other in quiet succession : violent shattering, hollow cough.
Sudden attacks : of general heat.
For a time : child remains without respiring ; during whooping cough.
Every few seconds : brings up a mouthful of bright colored frothy blood.
Every five minutes : lasting ten to fifteen minutes ; spasms.
Every eight to ten minutes : eructations.
Evening, 10, 15 minutes : attacks in pit of stomach.
Every quarter of an hour : vomiting.
Fifteen minutes : chill lasts.
Twenty minutes : shakes.
Half hour : tertian ague anteponing ; attacks of vomiting of blood.
One hour : chill lasts ; heat in head ; sweat after chill.
Eleven attacks in twenty-four hours : of spasms.
After a meal, especially P. M. : cough.
After dinner : dry, spasmodic cough.
Three or four stools a day.
Chill irregular.
Several times a day : hysterical spasms.
Every day at same hour : dyspepsia.
Every night : suffocative fits.
Every other day at same hour : dyspepsia.
Every fourth day : tormina and bilious vomiting.
For days : constant vomiting.
Every Saturday : tormina and bilious vomiting.
Every two weeks : menses.
Every six or eight weeks : anorexia and hypochondria.
Sixth week of pregnancy : abdominal pains, heat in epigastrium and vertigo.
Four times in seven weeks : menses.
For four months : occasional slight loss of blood.
In Autumn : diarrhœa ; dysentery.

Locality and direction

Right : eye < ; imbedded cornea, ulcerated ; opening lid gush of tears ; shooting pain from kidney down thigh to knee ; spasmodic contraction of arm ; slight contraction of corner of mouth regular movements of arm and hand ; ear cold.
Left : headache over eye ; cornea ulcerated ; pain in hypochondrium ; frightful spasms affecting side.
Downwards : pain from umbilicus to uterus.
From left to right : cutting pain in abdomen shooting across.
Turned to right : eyes.
From front to back : diaphragm feels as if pressed between two millstones.
Backwards : stiffening of body.
Down : uterine pains running.

Sensations

Pricking burning pains.
Headache, as if bruised, through bones of head and down to root of tongue ; as of a bruise of brain and skull ; as though brain was mashed ; as if stomach hung down relaxed ; diaphragm feels as if pressed between two millstones ; griping, as from a hand, each
finger sharply pressed into intestines ; as though bowels were grasped with hand ; as if all the bones in body were being torn to pieces ; strangling, as if from mucus in chest ; oppression of chest as from inhaling dust ; tickling in upper part of larynx, as from
vapor of sulphur ; as if hot water was poured into bowels ; feet as if paralyzed ; as if blood was vomited up ; sensation in femur as if dislocated ; as if joints had gone to sleep ; pain in bones as if bruised ; as if limbs were broken ; as if chill
was under skin ; as if forehead was being crushed ; as if all the bones were being torn to pieces.
Pain : over left eye ; in occiput and nape of neck ; in temples and forehead ; in hollow tooth ; in molars ; in diaphragm ; in loins and hips ; in stomach ; most severe in front of abdomen, extending to left hypochondrium to sides, to back and
base of chest ; in teeth ; in left hypochondrium ; about umbilicus toward uterus ; in abdomen ; in heart ; in uterus ; in small of back ; in limbs ; at umbilicus ; in epigastrium ; in lower bowels and kidneys ; in joints.
Violent pain : in abdominal region and bladder.
Intense tearing pains : in eyes.
Intense headache : extending to root of nose and throat.
Severe raging headache.
Acute pain : after miscarriage.
Violent distress : in pit of stomach.
Severe pains : radiating in abdomen ; in kidneys ; about umbilicus.
Cutting pain : in belly ; near umbilicus ; through abdomen from left to right ; in abdomen and urethra.
Anxiety : about precordia.
Piercing pain : through all cranial bones into roots of teeth.
Pinching pain : in both hypochondria and region of pit of stomach ; around umbilicus downward to uterus.
Shooting pain : through eyeballs ; from right kidney down thigh to knee ; across abdomen ; in kidneys ; in chest.
Stitches : in vertex or forehead ; from navel to uterus.
Fine and violently stinging pains : in head.
Stinging pain : in head ; in fauces.
Beating pain : in head ; in pit of stomach ; in stomach.
Throbbing : in head ; of heart ; frontal headache.
Jumping headache.
Painful concussions : in stomach and head.
Clutching pains : in stomach ; in abdomen.
Cramp : between scapulæ ; in thighs ; in chest.
Griping : in intestines.
Squeezing : in abdomen.
Stupefying headache.
Pressing pain : in stomach.
Intense aching : in back and bones.
Aching : in forehead ; in head ; in bones.
Pressive frontal headache.
Constant pressing pain : in pit of stomach.
Bearing down pressure : to uterus and anus.
Tensive pain : in occiput and nape of neck, extending to shoulders ; in eyes.
Sense of excoriation ; in chest.
Painful soreness : of occiput and neck.
Burning : in urethra ; in palms of hands.
Smarting : eruption on margin of lips ; in mouth and on tongue ; of eyes.
Sore pain : in chest.
Sore feeling : in abdomen.
Soreness : of fauces.
Bruised feeling : of limbs.
Tenderness : about umbilicus.
Painful fulness : in pit of stomach.
Violent pressure : over uterus and rectum.
Indescribable sick feeling : in stomach.
Heat : in head ; in epigastrium ; in stomach ; dry and extremely uncomfortable.
Dull drawing : in head to and fro.
Dryness : of fauces ; of mouth.
Distress : about navel.
Sense of emptiness : of stomach.
Pressure : in throat ; in stomach ; in bladder ; in pit of stomach.
Uncomfortable feeling : in epigastrium.
Constriction : in throat and chest.
Oppression : of chest.
Heaviness : of head ; of thighs ; in forehead.
Strangling : with cough.
Spasmodic tightness : of chest.
Contractive feeling : in throat and chest.
Tickling : at entrance of trachea ; from upper portion of larynx to lower extremity of bronchi.
Bubbling : in chest.
Weakness : of thighs.
Trembling : internal.
Coldness : of upper part of body ; of feet ; of extremities ; of one hand.
Internal chill.
Itching : spot on right chest ; at anus ; of calves.

Tissues

Muscular awkwardness.
Hemorrhages : bright red, from all the orifices of body ; after mechanical injuries.
After exposure to cold and rain.
Plethora, fat children.
Skin and mucous membranes pale ; pulse small, soft ; chilliness ; little appetite ; constipation ; marked anemic murmurs ; great debility and weakness ; finally could hardly eat anything ; nausea and vomiting following slightest amount of
food ; great emaciation ; headache, as if forehead was being crushed, with nausea ; eruption on forehead and cheek ; scanty menses ; querulous, not pleased with anything ; hands cold ; hysterical.
Cholerose gastric symptoms, nausea, vomiting, diarrhœa.
Dropsy in internal parts.
Skin and muscles lax.
Pain as if bruised in all the bones.
Pains as if all the bones were being torn to pieces ; with vomiting and pains in bowels.
Icterus ; rickets ; atrophy.
Has an unmistakable relation to the voluntary muscles ; in every kind of convulsions in children, in tonic, and especially in clonic convulsions, from the distortion of face, rolling of eyes and clenching of thumbs to the most severe epileptic spasms, particularly if there is
nausea.

Touch. passive motion. injuries

Pressure : stomach and hypochondria sensitive.
When biting on hollow tooth : pain in it.
After mechanical injuries : hemorrhage from lungs.

Skin

Itching, unchanged by scratching.
Itching of skin, with nausea ; has to scratch till he vomits.
Miliaria rubra, with dyspnœa, colic and nausea.
Miliary rash on forehead, temples and cheek.
Rash of the lying in.
Suppressed eruption with cool skin.
Eruptions suppressed, or tardily appearing, with oppression of chest ; vomiting and tickling cough.
Herpetic eruption at wrist joint and anus, with red blotches after scratching.
Erysipelas, the redness leaves too soon, with renewed vomiting.
Reaction so weak that eruption develops tardily or does not appear at all ; anxious oppression, or constriction of chest ; irascible, irritable, particularly at night, preventing sleep, and causing great anxiety ; severe tickling cough, with blueness of face and dyspnœa. θ Measles.
Fever, < towards night ; sleeplessness ; complete loss of appetite ; nausea ; despondent and lachrymose ; groaning. θ Scarlet fever.
Vascular erethism with tardy development of eruption ; anxious constriction of chest ; restless tossing about. θ Scarlet fever.
Delayed eruption in scarlatina, with vomiting, diarrhœa, oppression and anxiety.

Stage of life, constitution

Women and children ; emphysematous individuals.
Girl, æt. 6 weeks, eight days after birth caught cold ; inflamed eyes.
Girl, æt. 3 months, after receiving eight drops of laudanum ; opium poisoning.
Child, æt. 17, weeks, scrofulous ; vomiting and diarrhœa.
Child, æt. 22 weeks ; spasms.
Child, æt. 30 weeks, pale, fat ; spasmodic cough.
Boy, æt. 3, after overloading stomach ; diarrhœa.
Boy, æt. 4 ; ague.
Boy, æt. 4 ; eclampsia.
Boy, æt. 10, sanguine, scrofulous, after eating pork ; diarrhœa.
Girl, æt. 11, black hair and eyes, subject to attacks of ague for which quinine was taken ; intermittent.
Boy, æt. 14 ; chronic vomiting.
Girl, æt. 15 ; ague.
Girl, æt. 16 ; melena.
Man, æt. 17, sanguine temperament, suffering from purpura, after catching cold ; spasms.
Girl, æt. 18, graceful, menses profuse ; ague.
Man, æt. 20, weak, brunette, melancholic ; ague.
Woman, æt. 21 ; ague.
Woman, æt. 22 ; ague.
Woman, æt. 23, small, pale, irritable, brown hair, menses appeared at 17 but were very scanty ; anemia.
Woman, æt. 23, blonde ; hematemesis.
Women, æt. 24, strong, good constitution, married three months, pregnant six weeks ; uterine hemorrhage, with abortion.
Woman, primipara, after tedious labor, terminated by instrumental delivery ; hemorrhage from uterus.
Woman, suffering four weeks ; flooding.
Woman, æt. 24 ; hysterical spasms.
Girl, æt. 25, strong ; hematemesis.
Man, æt. 25 ; chronic nasal catarrh.
Woman, æt. 26, large, robust, fair complexion, has suffered four years ; tormina and bilious vomiting.
Swedish girl, æt. 26, ill for three years, has taken much quinine ; intermittent fever.
Woodcutter, suffering for years, every spring and fall ; ague.
Man, suffering some weeks ; ague.
Girl, æt. 28, anemic ; hematemesis.
Man, æt. 28 ; cholera.
Woman, æt. 30, blonde, weak ; ague.
Soldier, æt. 34 ; dysentery.
Negro, after piercing sole of foot by stepping upon a fish bone ; tetanus.
Woman, æt. 35, ill two weeks ; ague.
Woman, æt. 35 ; ague.
Woman, æt. 38 ; cough.
Woman, æt. 38, has taken quinine ; intermittent fever.
Man, æt. 39, tuberculous, after exposure to wet and cold ; hæmoptysis.
Woman, æt. 39, married ; vomiting.
Woman, æt. 40, four months after abortion ; hemorrhage.
Woman, æt. 42, suffering 2 1/2 years ; vomiting.
Man, æt. 44, ague.
Man, æt. 45, suffering four weeks ; constant vomiting.
Woman, æt. 47, suffering six weeks ; choroiditis.
Man, æt. 54, suffering three months ; chronic vomiting.
Woman, æt. 54, good constitution, menstruation ceased six months ago without inconvenience, after taking journey during which she became chilled ; hæmaturia.
Widow, æt. 54, since attack of cholera four years ago, continual suffering in abdomen ; dysentery.
Man, æt. 62 ; ague.
Woman, æt. 72, melancholic temperament, brunette, thin, tendency to hemorrhoids and abdominal affections ; spasmodic cough.

Relations

Antidoted by : Arnica, Arsen., Cinchona, Nux vom., Tabac .
It antidotes : Alum., Arnica, Arsen., Cinchona, vapors of copper, Dulcam., Ferrum, Lauroc., Opium, Sulph. ac., Tabac., Tart. em .
Compatible : is followed well by Arsen . (cholera infantum, debility, colds, croup, chills), Bellad., Bryon., Cadmium sulph . (yellow fever), Calc., Chamom., Cinchona, Cuprum, Ignat., Nux
vom., Phosphor., Pulsat., Sepia, Sulphur, Tart. em., Tabac., Veratr .
Complementary : Cuprum .

Lectures on Homoeopathic Materia Medica

James Tyler Kent · Lectures on Homoeopathic Materia Medica · homeoint.org / Séror HTML text (Kent d. 1916; public domain)

Lecture

Ipecac. has a wide sphere of action among acute sickness. Most of its acute complaints commence with nausea, vomiting.

The febrile conditions commence with pain in the back between the shoulders, extending down the back, as if it would break, with or without rigors, much fever, vomiting of bile and seldom any thirst. This is the general aspect of the beginning of an Ipecac. fever or gastric. trouble or chill in intermittents or bilious attacks.

The stomach is disordered. There is a sense of fullness in the stomach, cutting pains in the stomach and below the stomach, going from left to right. The cutting pain in colic goes from left to right. The patient is unable to stir or breathe until that pain passes off. It holds him transfixed in one position, coming like the stabbing of a knife in the region of the stomach, or above the navel, going from left to right, and is attended with prostration and nausea.

Nausea

All the complaints in Ipecac. are attended more or less with nausea; every little pain and distress is attended with nausea. The sufferings seem to centre about the stomach, bringing on nausea.

There is continuous nausea, and gagging. The cough causes nausea and vomiting. It is a dry, hacking, teasing, suffocative cough, accompanied by nausea and vomiting. He coughs until his face grows red, and then there is choking and gagging. With every little gush of blood from any part of the body there is nausea, fainting and sinking.

Hence its value in uterine hemorrhages; bright, red blood with nausea; a little blood is attended with fainting or syncope, but the great overwhelming nausea runs through the complaints of this remedy. Though there is sometimes thirst, it is usually absent. When Ipecac. does its best work, there is thirstlessness.

With the Ipecac. fever, or with the chill, there is likely to be pain in the back of the head, a bruised pain through the head and back of the neck and sometimes down the back, and drawing in the muscles of the back of the neck. A congestive fullness in the head, a crushed feeling in the head and back of the head; the whole head aches and is full of pain.

Ipecac. is sometimes as restless as Arsenic., but the Ipecac. prostration comes by spells, whereas the Arsenic prostration is continuous. You will see Ipecac. patients tossing over the bed as much as they do when they need Rhus, turning and tossing, and moving the hands and feet, with restlessness.

This is especially the case when the spine is somewhat involved. Ipecac. has symptoms that look like tetanus it has opisthotonos, and it has been a useful remedy in cerebro-spinal meningitis with vomiting of bile, with pain in the back of the head and neck, and drawing of the muscles of the back, retracting the head.

Stomach

When cerebro-spinal meningitis has gone on until the patient is emaciated, when remedies have seemed but to palliate momentarily, and the whole body is inclined backwards, and there is vomiting of everything, even the simplest article taken into the stomach, the tongue is red and raw, and there is constant nausea and vomiting of bile, Ipecac. will cure.

Ipecac. cures inveterate cases of gastritis when even a drop of water will not stay down; everything put in the stomach is vomited, continuous gagging, sharp pain in the stomach, pain in the back, below the shoulder blades, as if it would break, vomiting of bile, continuous nausea and great prostration. Irritable stomach. It also cures when the abdomen is distended, and sensitive, a tympanitic state, when there is vomiting of bile.

Ipecac. has proved a useful remedy in epidemic dysentery, when the patient is compelled to sit almost constantly upon the stool and passes a little slime, or a little bright red blood; inflammation of the lower portion of the bowel, the rectum and the colon. The tenesmus is awful, burning, and continuous urging with the passage of only a little mucus, and blood. With this there is constant nausea; while straining at stool, the pain is so great that nausea comes on, and he vomits bile. At times, whole families are down with it. It runs through a whole valley and may be epidemic, but it commonly relates to endemics.

In infants, it is indicated when a cholera-like diarrhoea has been present and it ends in a dysenteric state, with continued tenesmus, and the expulsion of a little bloody mucus, the child vomiting everything it takes into the stomach; nausea, vomiting, prostration and great pallor. It is also useful in such conditions when the stool is more or less copious, and is green, and the child passes, frequently, copious quantities of green slime. Much crying when at stool, much straining, with passages of green slime, vomiting of green slime, and vomiting of green curds; milk turns green and is vomited.

Chest

The chest complaints of Ipecac. are interesting. Ipecac. is especially the infant's friend and is commonly indicated in the bronchitis of infancy. The usual bad cold that ends in chest trouble in infants is a bronchitis.

It is very seldom that an infant gets a true pneumonia, it is generally a bronchitis with coarse rattling. The child coughs, gags and suffocates, and there is coarse rattling which can be heard throughout the room, and the trouble has come on pretty rapidly. The child is pale, looks dreadfully sick, and sometimes looks very anxious. The nose is drawn in as if dangerously ill, and the breathing is such as appears in a dangerous case. Ipecac. will sometimes modify this into a very simple case, break up the cold, and cure the child.

In the old books, the pneumonia of infancy had a distinct and separate description, and the typical symptoms were those of Ipecac. You will see a great similarity of symptoms when you study Ipecac. and Ant. tart. together in chest troubles. If you have been studying them together, you will say,

"How do you distinguish them; they both have rattling cough and breathing, and both have the vomiting?"

Well, the Ipecac. symptoms correspond to the stage of irritation, while the T artar emetic symptoms appear in the stage of relaxation. That is, the Ipecac. symptoms come on hurriedly, come on as the acute symptoms, whereas the Tartar emetic complaints come on slowly. The latter is seldom suited to symptoms that arise within twenty-four hours, or at least the symptoms of Tartar emetic that arise in twenty-four hours are not of this class.

This group comes on many days later, comes on at the close of a bronchitis when there is threatened paralysis of the lungs; not in the state of irritation, not the dyspnoea from irritation, not the suffocation of that sort, but the suffocation from exudation, and from threatened paralysis of the lungs.

When the lungs are too weak to expel the mucus the coarse rattling comes on. Then there is the great exhaustion, deathly pallor of the face and sooty nostrils.

We see now that these two remedies do not look alike. If we observe the pace of the two remedies, we see that the complaints differ. It is not so much. that they belong to stages, although they do, but rather that Ipecac. brings on its symptoms rapidly and effects a crisis speedily, and that Ant. tart. brings on its symptoms slowly and effects a crisis after many days.

You can readily see the value of Ipecac. in whooping cough, for it has the paroxysmal character, the red face, and vomiting and gagging with the cough. The red face, thirstlessness, violent whooping, with convulsions, with gagging and vomiting of all that he eats are the symptoms that you will generally find.

Haemorrhages

I have hinted at the haemorrhages, and these open out a great field for Ipecac. I could not practice medicine without ipecac., because of its importance in hemorrhages. When I say haemorrhages, I do not mean those from cut arteries, I do not mean haemorrhages where surgery must come in; I mean such as uterine haemorrhages, haemorrhages from the kidneys, from the bowels, from the stomach, from the lungs.

You must know your remedies in haemorrhages; if you do not, you will be forced to use mechanical means; but the homeopathist who is well instructed is able to do without them. In the severest form of uterine hemorrhages, the homeopathic physician is able to do without mechanical means, except when mechanical means are causing the haemorrhage.

This does not relate to hourglass contractions, it does not relate to conditions when the after birth is retained, or when the uterus has a foreign substance in it, because under such circumstances manipulation is necessary.

A distinction must be made. But when we have simply the pure dynamic element to consider, simply and purely a relaxed surface that is bleeding, the remedy is the only thing that will do the work properly. When the uterus is continuously oozing, but every little while the flow increases to a gush, and with every little gush of bright red blood the woman thinks she is going to faint, or there is gasping, and the quantity of the flow is not sufficient to account for such prostration, nausea, syncope, pallor, Ipecac. is the remedy.

When with the gushing of bright red blood there is an overwhelming fear of death, Aconite. If your patient while going through the confinement has had a hot head, an uncontrollable thirst for ice cold water, and after the confinement, everything has gone on in an orderly way, and the placenta has been delivered, and although you have no reason to expect such haemorrhage it comes on, Phosphorus will nearly always be the remedy.

In those withered women, lean and slender, who are always suffering from the heat, who want the covers off and want to be cool, who have had a tendency to ooze blood from the uterus, and now have a haemorrhage that is alarming either with clots, or only an oozing of dark liquid blood, you can hardly do without Secale. A single dose of any one of these medicines on the tongue will check a haemorrhage more quickly than large doses of strong medicine.

The haemorrhage will be checked so speedily that in your earlier experiences you will be surprised. You will wonder if it is not possible that it stopped itself. In copious menstruation Ipecac. is often indicated When the woman has taken cold, or has a shock. In cases where she is not especially subject to copious uterine flow at the menstrual period, she is naturally alarmed, for it is something she has never bad before, and the flow is likely to continue for many days, attended with this weakness. All her power seems to go with a little gush of blood. Ipecac. will cure and end the menstrual flow normally. A fortunate thing in nature is the tendency to check haemorrhage, which is always good.

There are a large number of medicines that control haemorrhage, and these you must keep at your finger's ends. They belong to emergencies. You must know the remedies that correspond to violent symptoms and violent attacks. Ipecac. is full of hemorrhage. Vomiting of great clots of blood, continuous vomiting of blood in connection with ulceration. In persons who are subject to violent attacks of bleeding, who bleed easily, who have a haemorrhagic tendency, Ipecac. will control temporarily the haemorrhage when the symptoms agree.

Urines

Severe pain in the back in the region of the kidneys, shooting pains, frequent urging to urinate, and the urine contains blood and little clots of blood. The urine is extremely red with blood, which settles to the bottom of the vessel, and lines the whole commode with a layer of blood the thickness of a knife blade. Every pint of urine that it contains will have that coating of blood in the vessel; every attack of pain in the kidney is attended with that condition of the urine. Ipecacuanha will stop that bleeding. It is true that when patients have bled until they have become anaemic, and are subject to dropsy, Ipecac. ceases to be the remedy; its natural follower then is China, which will bring the patient in a position to need an antipsoric remedy.

Colds

Then there are the "colds."

Simple, common coryzas among the children. When a cold settles in the nose, and the nose is stuffed up at night or when the adult has a coryza, with much stuffing up of the nose, blowing of mucus and blood from the nose, much sneezing, and the cold goes further down and is followed by hoarseness, extending into the trachea with rawness, and finally into the bronchial tubes with suffocation and settling in the chest, think of ipecac.

The Ipecac. colds often begin in the nose and spread very rapidly into the chest. With these colds in the nose there is copious bleeding of bright red blood. Every time he takes cold in the nose he has copious bleeding; a tendency to nosebleed with the colds. The inflammation that comes upon the mucous membrane in Ipecac. is violent.

The irritation comes on suddenly, and the mucous membrane inflames so rapidly that the parts become purple, turgescent, and bleeding seems to be the only natural relief. Stoppage of the nose and loss of smell; the nose becomes so stuffed up that he cannot breathe through it.

With the head symptoms, with the colds, with the whooping cough, with the chill, and with many of the inflammatory complaints, the face becomes flushed, bright red, or bluish red, and the lips blue; with the chill the lips and the finger nails are blue. The chill is violent, sometimes congestive in character and often a rigor. The whole frame shakes, and the teeth chatter.

There are old incurable cases of asthma that are palliated by Ipecac. and carry around a bottle of it from which they say they get much relief. It is useful in cases of humid asthma, in cases of asthmatic bronchitis, when they suffer from the damp weather and from sudden weather changes; every little cold rouses up this bronchial attack, and he suffocates and gags when he coughs, or spits up a little blood.

He has to sit up nights to breathe, and the attacks are common and frequent. These patients say they get relief front Ipecac., and it is not surprising that Ipecac. relieves that state of asthmatic breathing, because it has such symptoms. Some of these cases are incurable, they are people advanced in life.

This remedy, more wisely administered, will give more relief. A powder of Ipecac. will break up the attack, so that the patient is comfortable, and then will go on in an ordinary sort of asthmatic way, until catching another cold. The cough is rattling and asthmatic.

Convulsions

As a convulsive medicine Ipecac. is not well enough known.

Convulsions in pregnancy. Convulsions in whooping cough; frightful spasms, affecting the whole of the left side, followed by paralysis; clonic and tonic spasms of children and hysterical women. Tetanus, rigidity of the body, with flushed redness of the face.

These are strong features of Ipecac., and they have not been sufficiently dwelt upon, and the remedy is not sufficiently known as having these states so prominently. Medicines like Belladonna are more frequently spoken of in the books and in treatises of spasms, yet Ipecac. is just as important a remedy to be studied in relation to spasms, and its action upon the spine.

Skin

In suppressed eruptions, the symptoms will very commonly point to Ipecac.

When the eruption does not come out, or an eruption has been driven back by cold, sometimes acute manifestations of stomach and bowels follow and colds settle in the chest from suppressed eruptions, Ipecac. will also cure erysipelas, when there is the vomiting, the chill, the pain in the back, the thirstlessness and the overwhelming nausea.

Ipecac. is often sufficient for the nausea and vomiting when the scarlet fever rash is slow to come out. Instead of the rash coming out as it should, Ipecac. symptoms come on in the stomach with nausea and vomiting. Ipecac. will check the nausea and vomiting, will bring out the eruption, and the disease will run a milder course.

The Therapeutics of Fevers

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

Characteristic

Adapted to cases where the gastric symp- toms predominate (Ant. c., Nux, Puls.).

In all diseases the constant nausea is guiding.

Nausea: with profuse saliva; vomiting of white, glairy mucus in large quantities, without relief; with distended abdomen; sleepy afterwards; worse from stooping.

Stomach feels relaxed as if hanging down (Ign., Staph.).

Stool: grassy green; white mucus (Colch.); bloody; fer- mented; preceded by griping, pinching pain about the umbili- cus, as from a hand, each finger seemingly pressing sharply into the intestines, aggravated by the slightest motion; cut- ting colic about umbilicus.

Hemorrhage: bright red from all the orifices of the body

(Erig., Mill.); uterine, profuse, clotted, heavy oppressed breathing during; stitches from navel to uterus; cutting across from left to right (from right to left, Lyc.); large ac- cumulation of mucus in the bronchi, difficult to raise (Ant. t.).

Cough: dry, spasmodic, constricted, asthmatic.

Difficult breathing from least exercise; violent dyspnœa, with wheezing and anxiety about the stomach.

Whooping-cough: child loses breath, turns pale, stiff and blue; strangling, with gagging and vomiting of mucus; bleeding from nose or mouth (Ind.).

Cough, with rattling of mucus in bronchi when inspiring (Ant. t.); threatened suffocation from mucus.

Pains as if bones were all torn to pieces (Lac c., Tub.—as if broken, Eup.).

Intermittent dyspepsia, every day or every other day at same hour; fever with persistent nausea.

Oversensitive to heat and cold.

Relations

Complementary: Cuprum. Nux and Puls. follow well when gastric symptoms correspond.

Aggravation

Slightest motion; worse in winter and dry weather; warm, moist south winds (Eup.); warm room; night.

Amelioration

Rest; closing the eyes.

Type

--Quotidian; tertian; quartan. Apt to postpone and become irregular; bilious; remittent; malarial; yellow.

Time

9 or 11 A. M. (10 to 11 A. M., Nat.) and 4 P. M.

Fever, without chill, at 4 P. M.

Cause

Irregularities and indiscretions in diet. Cases drugged with Quinine and Arsenic.

Prodrome

Violent retching; yawning, stretching, backache, headache, and profuse flow of saliva. Nausea.

Chill

Without thirst. Chilliness; he is always worse when in a warm place. External coldness with external heat. Chill worse in a warm room; or from external heat (Apis—> by external heat, Ars., Ign.), lessened by drinking and in the open air (Caust.—< by drinking, Caps., Cinch., Eup. Nux). Shivering; then chilliness, with coldness without thirst, at 4 P. M. The hands and feet are icy cold, and wet with cold sweat, with redness of one cheek and paleness of the other. Chill short and usually not severe, with or without nausea and vomiting. Paroxysm begins by an internal chill, made worse by external heat. Oppression of the chest.

Heat

With thirst; usually long-lasting, over whole body, with alternate coldness and paleness of face; nausea and vomiting; anxious, oppressed breathing, and dry, hacking cough, often excit- ing nausea and vomiting (cough with pleuritic stitches, Acon.—dry, teasing cough, before and during chill, Rhus—cough during chill and heat, Bry.); cold hands and feet. Sudden heat about 4 P. M., with sweat on arms and back; heat of entire body in the evening. External heat without internal heat (see Ign.). One hand cold, the other hot (Dig., Lyc.). Heat about head and face, sometimes with, often without, redness of cheeks, with dilated pupils and prostration of body and mind.

Sweat

Sudden attacks of sweat in a room; on upper parts of body; increased by motion and in the open air (Bry.—>by motion, Caps.); by being out of doors; cold on the forehead; sour sweat with turbid urine; stains yellow. Nausea and vomiting may be present. Always worse during sweat; better after it (> by sweating, Eup., Gels., Nat.). Light sweat in uncomplicated cases, but may be sour. Sweat becomes profuse only after abuse of quinine. May cough in sweating stage. Sweat may only amount to a cold, sticky, clammy feeling of the skin in some cases.

Tongue

At first clean; then coated yellowish or white; pale in all cases. Taste bitter, sweetish, like rancid oil. Desire for sweets, dainties.

Apyrexia

Never clear; disturbed by more or less gastric trouble (Ant. c., Puls.); loss of appetite, nausea and vomiting. Stomach feels relaxed and seems to hang down loose (Staph.). Aversion to food (aversion to meat, Arn.); bad taste in the mouth, languor and debility, with absence of sleep. Bitter taste of everything eaten (Bry.—everything tastes bitter except water, Acon.); profuse secretion of saliva, and vomiting after eating. Herpes labialis.

"Short chills; long fever; cold hands and feet; great oppression of the chest, he can hardly breathe. Always after previous drugging with quinine."—N. A. ROTH.

"Intermittent fever; nausea and vomiting predominate; slight chills are followed by much heat, with thirst and no subsequent perspiration. Fever consequent upon abuse of Quinine; slight chilliness without thirst, afterwards violent heat, with thirst, nausea and vomiting, dyspnœa, stitches in the chest, finally copious perspiration.”—LIPPE.

If paroxysm has been suppressed by Quinine, Ipecac- uanha is all the more indicated.

Relapses from improprieties in diet always an additional indica- tion for Ipecacuanha. This is a very common cause of a return of paroxysm and one frequently overlooked by physicians. In all forms and types of fever, reckless or over eating is perhaps the most frequent cause of relapse.

The persistent nausea, which does not always amount to vomiting, that is usually present in every stage, is the “guiding symptom” of Ipecac., although it may be and often is indicated when neither nausea nor vomiting is present. When fever returns in another form, after suppression by Quinine, and symptoms do not clearly point to any remedy, if nausea or vomiting were pres- ent in first onset of disease, Ipecac. will often cure.

In his “Forty Years’ Practice,” Jahr places Ipecacuanha at the head of the list of remedies in the treatment of intermittent fever, and recommends its administration in commencing the treatment of every case. He says: “I almost always commence the treat- ment with Ipecac.³⁰, unless some other remedy is distinctly indi- cated. I give a few globules in water, a teaspoonful every three hours, beginning immediately after the chill. By pursuing this course I have cured many cases of ‘fever and ague’ by the first prescription, thus saving myself a good deal of unnecessary seeking and comparing. If it does not help altogether, it changes the character of the fever so that Arn., Ars., Ign., Nux, etc., will complete the cure.”

This advice is also given by J. S. Douglas in his work on Inter- mittent Fever, p. 80; and a number of our closest and most suc- cessful prescribers have adopted it, with apparent success. H. V.

Miller says: “I am apt to give Ipecac. when I do not clearly see the indications for another remedy. Then it serves to clear up the case and prepare the way for some other remedy to complete the cure.”

I cannot endorse the above indiscriminate use of Ipecac., on principle; it is empiric practice, and will certainly be attended with many mortifying failures. That it is infinitely superior to the more prevalent, empiric and indiscriminate use of Quinine, and attended with less failures and less constitutional derange- ments, I have no doubt at all. If the attack can be traced to dietetic irregularities, this advice of Jahr is undoubtedly sound; the best proof being its success at the bed side. A case like the following very often occurs in practice:

A messenger is sent many miles for some medicine for "ague;" and that is all the information we can obtain. If we do not pre- scribe some one else will; and rather than lose a patient and have it said that we cannot cure "so simple a thing as ague" we make a "chance shot," and, unless we have found the "genus epi- demicus" of the season, are as apt to fail as to cure.

This is, in my opinion, the opportunity to follow Jahr's advice and exhibit Ipecac.; and it would be infinitely better for our patient, our school of medicine, and our professional reputation, if we did so instead of sending Quinine. Ipecac. covers a much larger range of symptoms than Quinine, and, in a case like the above, will cure more patients.

In regard to this routine habit of prescribing Ipecac., Dr.

Chargé says: "I have known practitioners, highly commendable in other respects, who always began with Ipecac, under the pre- tense that, after it, the case was better outlined and the choice of the true specific was consequently easier. This is simply an encouragement to indolence. Ipecac. presents itself to us with so clearly defined features, that it is impossible with a little attention not to recognize at once the cases which call for it.

Analysis

Persistent nausea. Indiscretions in diet may have caused the original attack, or the relapse. Chill < in a warm room and from external heat. Suppressed by abuse of quinine. When the paroxysm is changed and masked by drug- ging.

Chill not marked and distinct, being either a chilliness up and down the back or a mingling of chills and heat; half an hour the longest. If thirst in chill, may continue during chill and heat, although rarely so severe in heat. Great lassitude and weariness during chill. Chill usually followed by nausea and vomiting, first of contents of stomach, afterwards of bile. Hot stage lasts four or five hours, and even all night. Sweat light, partial, on single parts (Bry.), sour. If mixed with Quinine cachexia, profuse, sour, and soaking the bed through.

In the irregularity of the different stages of the paroxysm, as well as the universality of its indication, Ipecacuanha resembles

Arsenic, and should always be thought of where indiscretions in diet may have been the cause of original attack, or have produced a relapse. The greatest prostration occurs during chill (the pros- tration of Arsenic. is greatest after heat).

Always $<$ during sweat.