Hamamelis virginiana

Volume I — Special Symptomatology

(Witch Hazel)

Description. — This is an indigenous shrub, sometimes called Winter Bloom, Snapping hazel nut, Spotted Alder, etc. It consists of several crooked, branching trunks, from the same root, from one to two inches in diameter, ten or twelve feet in height, and covered with a smooth, gray and spotted bark. It is a much larger shrub than the edible hazle-nut, which has a straight trunk, not spotted, but brownish. The Hamamelis virginica grows in almost all sections of the United States, especially in damp woods, flowering from September to November, when the leaves are falling, and maturing the seeds the next summer. The bark and leaves are the parts used in medicine ; they have a pleasant, aromatic odor, and a bitter, astringent taste, leaving a sense of pungency and sweetness in the mouth.

Officinal Preparations. — Tincture of the bark ; dilutions.

Analogues. — Aesculus, Arnica, Bovista, Oollinsonia, Erigeron, Galium, Lycopus, Senecio, Trillium.

Head.

• Crowding fullness in the head and neck, also in forehead. Feeling as if a bolt was passed from temple to temple, and tightly screwed.

° Passive congestion, or venous stagnation. Fullness in the forehead, with pressing sensation in the roots of the tongue.

Nose.

• Epistaxis, with feeling of tightness of the bridge of the nose.

• Profuse epistaxis, idiopathic or vicarious. ° Epistaxis of childhood, passive, venous.

° Oozing of very dark blood from the nose in a hemiplegic old man. {Preston.)

Mouth.

Dryness of the mouth; tongue feels as if burnt. Blisters on the sides of the tongue. Tongue coated white, with flat taste. ° Bleeding from the gums. 0 Burns of the tongue and lips.

° Hemorrhage after extraction of teeth. {Cushing.)

Eyes.

Painful inflammation of the eyes; excessive congestion.

° Conjunctivitis, from the burn of a flame. {Dr. Holcombe.)

° Conjunctivitis, from a splinter in the eye. {Ib.)

Throat.

Dry, thirsting feeling of the throat, not relieved by water. Fullness in the neck; have to sleep with the neck free of any covering.

Feeling as if something had lodged in the fauces.

• Tonsils and fauces congested.

° Hemorrhage from the throat and fauces. ° Varicose condition of the throat and fauces.

Stomach.

Burning in epigastrium; sharp pains in the stomach Nausea, from pain in the testicles. 0 Heematemesis of black blood.

Abdomen.

Constant distress in the umbilicus. Burning in the epigastrium and umbilicus. Drawing pains in the abdominal muscles. 0 Haemorrhage from portal congestion. " Hemorrhoidal dysentery.

° Painful and bleeding haemorrhoids. Constipation, with dry, hard stools, coated with mucus. Ineffectual desire for stool.

Urinary Organs. Scanty, high-colored urine.

• Irritation of the urethra, followed by a discharge and ardor

urinae.

° Hematuria, from passive congestion of the kidneys.

° Catarrh of the urethra, with disease of the prostate gland.

0 Ardor urinae in the female.

Generative Organs. (Female.) * Hemorrhage from the uterus of bright red blood, midway between the menstrual periods.

• Active uterine hemorrhage in a young lady.

• Acute vaginitis, with spasmodic action and painfulness of

the vagina.

• Prurigo of the vulva, with vaginitis and vaginismus. ° Leucorrhoea profuse and almost constant.

° Vaginal leucorrhoea, bloody. 0 Ovaritis following miscarriage (left side). 3 Varicose veins during pregnancy. 0 Dysmenorrhoea, inflammatory or neuralgic. 0 Retention of the menses, with haematemesis, constant constipation and varices of the legs. 0 Vicarious menstruation.

0 Hemorrhage, blood flows steadily, venous in character, and

without uterine pains. ° Ovaritis — pain commences in the right ovary, passes down

the broad ligaments to the uterus. 0 Ovarian soreness and painfulness. ° Phlegmasia alba dolens (milk leg).

(Male.) Amorous dreams, with emissions, followed by lassitude, gloomy, depressing mood, and dull pain in lumbar region.

• Great prostration of the animal passions, with severe neuralgic pain in testicle, suddenly changing to bowels and stomach, causing nausea and faintness.

Drawing pains in testicles day and night, extending from the groins.

Profuse cold sweat of the scrotum at night.

° Enlargement of the right testicle, hot and painful, following

gonorrhoea. (Hale.) 3 Urethritis, with discharge of transparent mucus with pain. 3 Orchitis, one of our most valuable remedies; (used locally

and internally.) 0 Neuralgia of the testicles.

° Yaricosis of the spermatic veins (circocele). (Dr. D. S. Smith.)

Larynx.

Tickling in the larynx, with constant inclination to cough.

Chest.

Labored inspiration ; oppressive tightness of the lower part of the thorax, with inability to make a deep and full inspiration; breathing impossible in a recumbent position, and a crowding fullness in neck and head.

Pricking pain in the region of the heart for days, also in the superficial veins of both arms.

° Cough; haemoptysis, with dull frontal headache; taste of Sulphur in the mouth.

° Tickling cough, with taste of blood on waking.

° Slight hacking cough, with blood-spitting.

0 Haemoptysis in consumption.

Back.

Tearing pains across the small of the back, with fullness of

the joints of the legs.

Upper and Lower Extremities. Pricking pains in the superficial veins of both arms. Painful fullness of the joints of the legs, as if they would

burst, which soon extends to all the joints of the body. Severe drawing pains in flexor muscles, wrists, hands and fingers. ° Varicosis of the limbs. ° Phlegmasia alba dolens. Articular rheumatism, with swollen and painful joints. 0 Phlebitis of the vessels of the extremities. c Varicose ulcers.

Volume II — Special Therapeutics

This is an indigenous shrub, sometimes called Witch-hazel, Snapping hazelnut, Spotted alder, etc. It consists of several crooked, branching trunks from the same root, from one to two inches in diameter, ten or twelve feet in height, and covered with a smooth, gray, and spotted bark. It is a much larger shrub than the edible hazelnut, which has a straight trunk, not spotted, but brownish. The Hamamelis virginica grows in almost all sections of the United States, especially in damp woods, flowering from •September to November, when the leaves are falling, and maturing the seeds the next summer. The bark and leaves are the parts used in medicine. They have a pleasant, aromatic odor, and a bitter, astringent taste, leaving a sense of pungency and sweetness in the mouth. Water extracts their virtues. The shoots are used as “ divining rods ” to discover water and metals under ground,

by certain adepts in the occult arts. They have been used, also, by certain superstitious quacks for the cure of old ulcers, etc., by rubbing them on the diseased surface. Strange as it may seem, cures are alleged to have been made in this manner. There has always been a large amount of superstition connected with this shrub. The popular preparation known as “ Pond’s Extract of Hamamelis” is made from the leaves and twigs, by a process of distillation. It is now used by all schools of medicine as an anodyne application. It cannot be expected, however, that it will relieve or benefit all the diseases mentioned on the extensive labels of the manufacturer, and the physician who pins his faith thereupon will be disappointed.

The portion used in medicine is the bark of the branches and roots. The leaves and small twigs contain a proportion of the qualities of the shrub. A concentrated principle is obtained from the bark, and known as Hamamelin. It does not contain all the properties of the tincture. The article known as “ Pond’s Extract,” also the “ Distilled Extract,” prepared by some pharmaceutists, is largely used in our school, administered internally as well as by external application. For internal use, however, we should use the tincture of the fresh bark.

The Hamamelis has been used in homoeopathic practice for about twenty years. Several physicians claim the honor of introducing it into our practice, among whom are Hering, Okie and Preston. I believe Dr. Okie was the first to write concerning the medicine, but he says Dr. Hering first called his attention to the remedy.

Dr. liering, it seems, became acquainted with its alleged virtues while attending Mr. Pond, the manufacturer of the “ Extract ” which bears his name. Dr. Okie says : “ Hering proceeded at once, by scientific trials, to discern for himself whether the remedy did or did not possess any or all of the virtues attributed to it by the proprietor.” Dr. Hering recommended it for “ chronic effects from mechanical injuries,” “painful and bleeding haemorrhoids,” “severe pleuritic stitches supervening on tubercular phthisis.” He thinks it is like a “ union of Aconite and Arnica.”

The various provings of Hamamelis, although none of them are as full and thorough as they ought to be, together with the extensive clinical experience with the medicine in all its preparations, has greatly enlarged our knowledge of its sphere of action since its first introduction. That sphere of action is, however, very limited.

Its action seems to be confined almost altogether to the venous system of bloodvessels. It may be called the Aconite of the veins, acting upon those vessels as Aconite acts upon the arteries. Its primary action appears to cause a spasm of the vasomotor nerves which supply the veins (if a drug is capable of causing a spasm of those nerves, and not, at the same time, those of the arteries). It also acts as an irritant to those vessels to such an extent as to cause a condition favorable to, if not actually ending in inflammation of their coats. The secondary action leads to the other extreme, and we have paresis of those nerves, and thence paralysis of the coats of the veins, leading to varicosis, venous congestion, haemorrhages, and even structural lesions.

It is primarily homoeopathic, then, to phlebitis, not only of the venous system generally, but of the venous system of the lungs, and the venous side of the heart. It is also indicated for certain anomalous pains (supposed to be neuralgic) which arise from diseases of the veins. In these diseases it should be used internally in the medium dilutions, and not very strong externally.

It is homoeopathic, secondarily, to venous congestion or stagnation ; to dilatation, paralysis, and rupture of the coats of the veins ; to varicose ulcers; and many diseases depending on venous obstruction.

When I enumerate the various disorders for which the Ilatnamelis is recommended, you will see that they can nearly all be included under the above category.

Dr. Hughes, one of England’s most acute medical observers, gives in the following quotation some symptoms brought on by its use. They seem to show that in causing contraction of the veins of the head, it indirectly caused some arterial engorgement, a condition not unlikely to follow arrest of venous haemorrhage.

Dr. R. Hughes, in giving his experience with this remedy, says :

I have the greatest confidence in Hamamelis in phlebitis, in the various forms of varicosus, and in venous haemorrhage. It is not always successful in phlegmasia alba dolens, but there is good reason to believe that in this disorder the mischief is as often in the lymphatics as in the veins. In varicose veins of the leg I conjoin its external with its internal use, laying strips of calico soaked in a weak lotion of one part to twenty, along the enlarged vessels, and supporting all with a bandage. The pain is relieved and the veins much reduced in size. In “ bleeding piles ” the first or second dilution of Hamamelis is a most valuable remedy. In passive haemorrhage from all parts, whether nose, lungs, stomach, or bowels, I have the utmost confidence in its use. I think that the haemorrhages it cures depend rather upon the state of the bloodvessels than on that of the blood. Its value in varicosus, and the absence of any report of its curative action in purpura, point in this direction. The following, moreover, is a casein point: I was treating a young lady suffering from a complication of disorders, amongst which were almost daily epistaxis and throbbing headache. To check the epistaxis, I put a few drops of the mother tincture of Hamamelis in a tumblerful of water, and ordered a dessertspoonful to be administered alternately with the China, which was being administered for the headache. The first dose of Hamamelis was followed by a flushing of the face, the most distressing throbbing, aching, and sense of fulness in the head. These symptoms gradually subsided, and the intermediate dose of China was taken without any appreciable result. The second dose of Hamamelis, however, was immediately followed by the same symptoms as at first, the head feeling as if it would burst. I stopped the remedy, and the epistaxis recurred next morning as usual. In a day or two I resumed it, giving it in the third decimal dilution. Again the dilatation of the cerebral vessels took place, though the symptoms were not as severe as on the first occasion. This patient has been very sensitive to all medicines, but I see no reason to suppose the effect of Hamamelis upon her to be exceptional otherwise than regards quantity.

In menorrhagia I think Hamamelis less often useful than Ipecacuanha, Sabina, and Secale. In haematuria, also, it yields to Terebinthina and Ferrum muriaticum, probably because this haemorrhage is dependent more frequently upon the state of the renal or vesical tissue, than upon that of their bloodvessels.

Of the remedies mentioned by Hughes as controlling haemorrhages none affect directly the veins as does Hamamelis.

Of its real action on the brain we know but little. It may be supposed, from analogy, to cause the same conditions there as elsewhere. Hr. Hughes’s experiment seems to prove that some arterial congestion may be temporarily caused by it.

The symptoms would seem to indicate a condition of passive congestion or venous stagnation. In headache, preceding epistaxis, this may prove an excellent remedy. Many cases are only relieved by bleeding from the nose. The Hamamelis acts by removing the cause, and in this manner arrests the bleeding, if present, and removes the condition upon which it depends. We

have but little clinical testimony as to its value in cephalalgia. It will probably never be found as useful as Belladonna, Aconite, or Gelseminum.

We have found in the various journals nearly a hundred cases of epistaxis, some of them of an alarming character, which were promptly arrested by the use of Hamamelis in some form. Dr. Belcher cured a severe case in a boy aged fourteen, with Hamamelis 3d, one-eighth of a drop. The bleeding had not returned several months after.

Dr. Preston, in an article on venous haemorrhages, writes :

Epistaxis, or bleeding from the nose, forms the most common haemorrhage of childhood, and in a great proportion of cases is simple and perfectly harmless. When it is dependent upon active congestion it is usually arterial and proves its own remedy ; when it is the result of mechanical congestion, or forms one of the developments of the haemorrhagic diathesis, it is passive and probably venous.

Dr. Preston gives an interesting case illustrating its treatment with Hamamelis:

An old gentleman, hemiplegic, who had been subject to occasional attacks of haemorrhage from the nose, often profuse and very debilitating, and on several occasions requiring Mr. Abernethv’s operation of plugging the nostrils before it could be stopped. He had now been afflicted at intervals of several days with slight oozing of very dark blood from the Schneiderian membrane, particularly three times a day, shortly after meals, corresponding to the rhythmical exacerbation of the pulse. After the afternoon meal the bleeding was very profuse. He was able to walk about, but complained of feeling very weak and faint, with occasional vertigo or confusion of ideas ; his countenance was pale, and his pulse decidedly haemorrhagic. I ordered him home, and to keep perfectly quiet ; to use a strong nourishing diet, with wine at each meal, and gave him China and Hamamelis 3d, in alternation, every two hours. I was sent for to his house in the afternoon and evening, and the bleeding had been almost constant, but slowly oozing from his nose since he got home ; by evening he was too weak and faint to sit up, but lay in bed with his head raised ; gave China and Hamamelis 1st. The haemorrhage increased, however, all the next day, when small pieces of linen were wet with Hamamelis and rolled funnel-shaped and pushed up the nostrils. No more haemorrhage, and in three days he was able to go about his business.

It has been used with benefit in haemorrhage from the buccal cavity, and that form which occurs after extraction of the teeth. Also for scalding of the tongue and mucous membrane of the mouth and fauces.

Dr. Holcombe once reported two cases of conjunctivitis treated

successfully by Hamamelis internally, and as a collyrium. In one case it was caused by the contact of a “puff of flame,” in the other by a “splinter in the upper palpebral conjunctiva.”

It would seem to be indicated for the effects of injuries to the eye. In whooping-cough the eyeball becomes congested from the violence of the concussion, and small vessels are ruptured. Hamamelis soon dissipates these extravasations. Pond’s Extract has quite a reputation for black eye from a bruise.

There is a condition of the fauces and throat which might not inaptly be designated a varicose angina. The posterior fauces, uvula, and pharynx are of a bluish hue, caused by distended veins which ramify on the surface ; this causes a fulness, with cough, and pain on swallowing, and sometimes hawking of dark-colored blood mixed with mucus. In cases of this character the internal and topical use of Hamamelis proves curative.

In haematemesis, when the blood is dark and grumous, and arises from derangement of the liver or spleen, this remedy, in appreciable doses, will promptly arrest it. In haemorrhage from the stomach, from ulceration, or other causes having a local origin, I prefer Sulphuric acid.

In melcena , or haemorrhage from the bowels, it is not useful unless caused by a congestion of the portal system , either direct or indirect.

Such haemorrhages often occur during the progress of hepatic derangements, and arise from ruptured portal veins. The haemorrhage may come from high up in the intestines, or, what is more commonly the case, from the haemorrhoidal veins.

In fact, it is in congestion, inflammation , and bleeding of haemorrhoidal vessels that the Hamamelis has gained its greatest popularity. It is prescribed internally in doses suited to the severity of the case (a less quantity in inflammation and congestion than in actual haemorrhage), and a lotion of Pond’s Extract, or dilute tincture, applied externally or injected into the rectum. It is claimed by eclectics that this anti-haemorrhagic power is due to the large percentage of Tannin it contains.

In 7000 grains organic and inorganic matter found in the bark, 400 grains is Tannin, 1038 is a “ particular bitter principle,” and the balance consists of the ordinary solids found in all vegetable

substances. The chief medicinal power doubtless lies in the bitter principle. The Tannin plays but an unimportant part in the curative action, for Tannin alone, nor Gallic acid, have any such specific action on the system.

Dr. Preston asserts that he succeeded in checking haemorrhage from ulcerating carcinoma of the bowels by means of this remedy.

In certain kinds of dysentery , many physicians use it with good results. The testimony is, however, that the blood is usually dark, in clots or patches, scattered through the mucus. (On the contrary, in the dysentery of Ipecac., Aconite, and Erigeron, the blood is bright red and often fluid.)

In haemorrhoidal dysentery, which is really a phlebitis of the haemorrhoidal vessels, the Hamamelis is truly specific. In this disease it rivals Aloes, with which it possesses many qualities in common.

In diarrhoea, the Hamamelis is said to have been found useful, but the indications for its use are not ascertained. It will require more extended provings and clinical experiments to establish its applicability to diarrhoea. I would suggest that it might be useful in mucous and serous discharges arising from derangement of the portal system.

It is in haemorrhoids that the Hamamelis has achieved some of its greatest victories. It seems to have extraordinary powers over this disease, not only as externally manifested in the form of hicmorrhoidal tumors, but against the primary cause, which is often located in the portal system. It has been used in this affection from the earliest history of our country. The aborigines first imparted a knowledge of its curative virtues to the first settlers. It is mentioned as a remedy for piles, used externally, in the works of the early “ botanic ” physicians. When Pond first sold his extract, it was recommended particularly for this complaint. Dr. Hering was Pond’s family physician, and was induced by him to try its efficacy in some diseases. In 1850 Dr. Ilering informed Dr. Bushman, a pupil of Dr. Okie, that he had used it successfully in “painful and bleeding haemorrhoids.” Dr. Okie was then induced to try its virtues, and in a letter to Hering, published in 1853, he says:

I next made use of the Hamamelis in a number of cases of painful and bleeding piles. Those cases in which it has proved most beneficial in my hands are characterized by burning soreness, fulness, and, at times, rawness of the anus; in the back a weakness or weariness, or, as the patients graphically express it, “ Doctor, my back feels as if it would break off.” The haemorrhage is generally profuse, and I have in several instances seen this latter symptom cured completely, with shrinking of the overloaded haemorrhoidal vessels so that the full, pouting look of the anus was changed to its own more natural, demure pucker, while the burning and itching, depending more upon cutaneous irritability, or some herpetic taint, still remained. I have here, likewise, made a wash of the remedy, applying it externally, while giving it internally in the more dilute form. Mr. T., a highly respected agriculturist, somewhere in the fifties, had been troubled with painful and bleeding piles for a number of years. On examination I found the anus surrounded with a crop of tumid haemorrhoidal veins, bluish in color, and the whole anus encircled with a red, erythemic halo. I found that he suffered with “ backache,” has a “ pasty ” mouth, digestion tolerable, was not much constipated. I gave Hamamelis, first dilution, six drops night and morning, and applied a lotion of one-third of the remedy and two-thirds distilled water. In a fortnight he called again, and I found him much relieved. I repeated the prescription, to be taken once a day, since which time he has remained well.

In haemorrhoidal troubles, the true analogues of Hamamelis are Aloes, iEsculus, Collinsonia, Nux vomica, Sepia, and Sulphur. It is used externally as a cerate, ointment, and lotion, and at the same time prescribed internally.

I do not believe it capable of curing long-standing cases of haemorrhoids, even when they are not of a character requiring surgical treatment, and for the reason that Hamamelis is not a medicine that affects the system deeply or profoundly ; its effects do not tend to assume a chronic character. In the treatment of chronic cases its proper sphere is that of an aid to the profounder curative action of Nux, Sulphur, Nitric acid and Podophyllum. In this respect it resembles HCsculus, Aloes, and Collinsonia.

Its action on the urinary organs has not been sufficiently studied. Does it cause and cure the same conditions in the kidneys that it does elsewhere ? Is there a venous engorgement of the kidneys calling for its use ? Can we diagnose a venous haematuria from one of arterial origin ? Is there a phlebitis of the kidneys? Is Hamamelis indicated in any stage of Bright’s disease?

I confess I am unable to answer these questions. Nor can they be answered till we shall poison animals with Hamamelis, and then make minute dissections and microscopical examinations

of those organs, as Dr. Jacobi, of New York, did in his experiments with Turpentine.

Many cases of haematuria and “bloody urine” have been reported cured by Hamamelis, but of their exact nature we are ignorant. I prefer Millefoil, Turpentine, or Gallic acid. I doubt its value in any inflammation of the bladder or urethra, although it is recommended in strangury and irritable urethra.

In some of the disorders of the organs of generation of women it has been found curative, namely, in some cases of metrorrhagia and vicarious menstruation. When the metrorrhagia occurs midway between the menstrual periods, and the blood has all the appearance of venous blood, or has been preceded by venous plethora, it is specific.

It may be useful in menorrhagia when the same abnormal condition precedes the flow, but in simple excess of the menses it is not indicated.

When the vicarious discharge is from the lungs, bowels, or hemorrhoidal vessels, here, too, is the Hamamelis indicated.

In leucorrhoea it is a domestic remedy which has always been popular. It is generally used in the form of a decoction of the bark and leaves, or as Pond’s Extract. Many of my patients habitually resort to one of the distilled extracts now in use, as an injection in leucorrhoea.

Dr. Paine (eclectic) says he has known Hamamelis to cause “ violent contractions of the vagina, and a smarting-burning sensation, followed by prurigo.” He asserts that it will cure “ irritations of the vagina.” Taking this as indication, I have tried this remedy in vaginismus. It did not cure my cases, although the patients thought it gave some relief from the abnormal sensitiveness when used as an injection or in the form of a cerate.

In pruritus , Pond’s Extract will often give relief when used as a wash, but it is not as effectual as a lotion of Borax or Carbolic acid.

Dr. Okie first used it in ovarian diseases. He reported a cure of ovaritis from a blow on the abdomen. There were violent pains, at times in the swollen and tender ovary, at other times radiating all over the abdomen, producing an agonizing soreness; menses irregular, with an aggravation of the ovarian pains at the

period. There was also exquisite tenderness of the vagina and os uteri, the latter very sensitive and swollen, as was the ovary when touched per vaginam.

It has become a very popular remedy, both internally and as a lotion, in all kinds of ovarian disorders with tenderness, pain, and swelling. You will not find it a specific in all cases, or any large proportion of them. The special pathological condition of the ovary calling for Ilamamelis cannot at present be definitely stated, but it occurs to me that it may be some trouble with the veins which return the blood from those organs.

Dysmenorrhoea has been treated successfully with Hamamelis, according to Burnett, Pattison, and some others, but I have not heard of its use of late in that disorder. Caulophyllum, Xanthoxylum, and Viburnum are so superior to it that it has probably fallen into disuse.

Dr. Pattison, of England, makes a curious assertion, that Ilamamelin possesses a peculiar power almost sui generis in assuaging the pain and preventing the periodical sufferings, while the tincture possesses none of this power. It is not easy to understand why an “active principle” of a plant can possess power differing from the tincture.

You will find one of the extracts very useful in allaying the pain and tenderness of varicose veins in the limbs of pregnant women. I have seen equally good effects from its use, internally and topically, in 'phlegmasia alba dolens , when the pathological condition is a phlebitis, and not a lymphangeitis. The two conditions are often confounded, for, as Dr. Preston says, milk-leg is as often an affection of the lymphatics as the veins.

As might be expected, the Hamamelis affects the organs of generation of men. The testicles are homologous to the ovaries, and it has a deservedly high reputation in orchitis when arising from injuries (where it rivals Arnica) or from idiopathic inflammation. It is not as useful in orchitis from metastasis of gonorrhoea, in which case Pulsatilla and Clematis are more appropriate.

The symptoms in Burts’s proving indicating its use in spermatorrhoea have not been verified, and unless turgescence or inflammation of the spermatic veins is at the bottom of the disorder I do not imagine it will prove useful.

In neuralgia of the testicles, as well as ovarian neuralgia, it may prove palliative, but I have not known any cures performed by Hamamelis.

Cirsocele, or varicosis of the spermatic veins, has been treated successfully by lotions of Pond’s Extract, or dilute tincture, the same being given internally.

If there is such a disease as pulmonary phlebitis, as suggested by Preston, who surmises that many cases of “quick consumption” are of that character, the Hamamelis ought to prove curative for it.

He supposes it to arise from local injuries to veins in distant portions of the body, or to the absorption of pus into the veins. In the former case I would advise it to be alternated with Arnica; in the latter with Carbolic acid.

Hamamelis has cured cough and haemoptysis, with a taste of Sulphur in the mouth, and dull frontal headache. Also, “tickling cough, with a taste of blood on waking.” In haemoptysis it is considered by some to be a remedy par excellence, applicable to nearly all cases ; but this is going too far. It can never take the place of Aconite, Collinsonia, Cactus, or Lycopus. Dr. Preston (“ Diseases of Veins ”) says :

In general we look upon Hamamelis as a specific for passive venous haemorrhages, and we have seen it successful in arresting this particular form of bleeding from the pulmonary mucous membrane ; but we speak only from a few years’ experience, and that of a few observers, and therefore we must be impartial enough to mention a few of those remedies which other practitioners have recommended as useful in the cure of some forms of haemoptysis: Aconite, Ipecac., Ferrum aceticum, Arnica, Millefoil, etc. Dr. E. M. Payne reports the following case: A young lady, aged 16, was seized while at school, and without any premonitory symptoms, with blood-spitting. The patient was of slender build, light hair, blue eyes, fair complexion, lax fibre, and phthisical diathesis ; menses regular and normal. The blood-spitting commenced with a slight hack, and continued, with scarcely a moment’s intermission, up to the time of my visit, a period of nearly an hour. I found her lying upon a sofa, calm, with a napkin in hand nearly saturated with apparently pure venous blood, and spitting about the amount of a teaspoonful at intervals of one or two minutes. The blood came into the mouth without any effort. She described it as issuing about ten inches below the right clavicle, in a warm current, making apparently a tortuous course, and at the same time there was a sensation in that region as from the pressure of a hard body. Pulse somewhat accelerated — eighty-five. Ferrum aceticum was given, but caused no improvement in three hours. Millefolium, Aconite, Ipecac., and

Belladonna caused no amelioration. Hamamelis, four drops of the tincture to half a tumbler of water. A spoonful was given. The bleeding immediately ceased, and did not afterwards return. I have never used the Hamamelis successfully in cases of blood-spitting when the blood was of light-red, fluid, frothy in appearance, or raised by much cough.

Do not forget the value of Hamamelis in haemoptysis, when it is vicarious, from non-appearance of the menses, alone or in alternation with Senecio.

The greatest triumph of Hamamelis has been in the treatment of varicosus of the limbs. Dr. Preston, writing on varicosus, remarks.*

Homoeopathy has, as in many other cases, directed us to a specific remedy which, in my practice, as well as in that of a number of my colleagues in this section of the country, has been attended with uniform success in the treatment of this annoying disease. Since 1851 (six years) I have prescribed Hamamelis in upwards of fifty cases of varicose veins of the lower limbs, and in no single case has it failed to make a decided curative impression ; but in the great majority of cases it has, thus far, at least, proved a radical cure. My plan is : First, to bandage the limb tightly, from the arch of the foot to a little above the knee, or to the hips if the varices are above the knee, and the best bandage in my opinion is an elastic silk stocking, manufactured for the purpose. Under this, compresses of linen are laid ovei the dilated veins, and kept wet with Hamamelis tincture, or Pond’s Extract. I give the 3d dilution internally, two or three times a day. Some few cases, with large, indolent ulcers on the tibia or malleolus, have been under treatment a year, but most of them have been cured, or, at least, have disappeared, in less than half that time. The crowning point of its virtues (Hamamelis) rests in its peculiar prompt action in cases of phlegmasia alba dolens, and in varicose veins. In old cases of varicosus I have never seen its equal, and have cured many cases of varicose veins of the leg and foot which had resisted all other treatment for years.

Dr. Belcher reports several cases of varices, in pregnant women, cured by Hamamelis. (See cases under “ Organs of Generation of Women.”) Dr. Barrows found this remedy a valuable auxiliary in the treatment of a child with the following symptoms : “ Inflammation of the femoral vein, with the erysipelas spot near the groin, and over the vein, spreading over nearly one-half the thigh, with flexion of the leg ; swelling of the entire leg and foot, with tension ; heat and pale appearance of the limbs ; scanty urine, stiffening the linen (albuminous); tympanites; oedema of the whole body, limbs and face. Calcarea, Hepar sulphur, and other remedies were used.” (See case in full, in the “ North American Journal,” vol. vi, page 317.)

The “Homoeopathic Review” for April, 1864, contains a case of phlebitis, reported by Dr. H. Robinson, Jr., cured by Hamamelis. The symptoms were: “ Great pain in the right leg, from the knee to the hip; leg much swollen, and quite sensitive to the touch. The cutaneous veins were hard, knotty, swollen, and painful. The skin erysipelatous ; pulse small and wiry; much thirst and no appetite ; bowels costive; urine red and scanty; veins of the abdomen hard, like cords, red and painful. Gave Hamamelis 1st, five drops in half a goblet of water.” Cured in ten days.

Some physicians consider the Hamamelis of the greatest advantage in all cases of articular rheumatism with swollen and painful joints; as a local application, it seems to possess decided anodyne properties. They advise that cloths or cotton-wool, wet in the dilute tincture, be applied constantly to the affected parts. I do not believe it has any curative power over rheumatic affections.

The remedies most closely allied to Hamamelis in haemorrhages are Lycopus, Collinsonia, Trillium, and Pulsatilla.