Lobelia inflata

Volume I — Special Symptomatology

(Indian Tobacco.)

Botanical Description. — This plant is generally known as wild or Indian Tobacco, and is an annual or biennial indigenous plant, more commonly the latter, with a fibrous, yellowish white root, and an erect, angular, very hairy stem; in the full-sized plant, much branched, and from six inches to three feet in height. The leaves are alternate, scattered, sessile, ovate-lanceolate, serrate, veiny, hairy. The flowers are small, numerous, pale-blue, on short peduncles, each originating from the axil of a small leaf. The calyx consists of five subulate segments. The corolla is tubular, small, slit on the upper side and ventricose at the base ; the limbs bilabiate ; tube prismatic; segments spreading and acute, two upper ones lanceolate, two lower ones oval; anthers united into an oblong, curved body, purple; filaments white; style filiform; stigma curved, two-lobed, and enclosed by the anthers; capsule, two celled, ovoid, inflated, striated, ten-angled and crowned, with the persistent calyx. Seeds, numerous, small, oblong, brown.

Officinal Preparations. — Tincture of the whole plant or seeds ; triturations of the seeds; dilutions.

Analogues. — Aconite, Euphorbia, Ipecacuanha, Lachesis (?) Squilla, Tabacum, Tartar emeticus, Veratrum album, Veratrum viride.

Sensorium.

Great dejection with exhaustion, and sobbing.

• Fear of death, with difficulty of respiration.

• Great mental depression.

Insensibility and loss of consciousness.

Head.

Vertigo, with nausea; pain in the head and trembling; agitation of body.

• Pressive pain in the occiput, with dull heavy pain around

forehead, from one temple to the other. Sudden shocks through the head.

Chilliness of the left side of the head, with feeling as if the hair would rise on end.

• Pressive headache at the occiput, left side; worse at night

and on motion.

Continual, periodic headache in the afternoon ; and in the evening till midnight.

Eyes.

Pressing pain in the eyeballs, with intense itching. Intense smarting of the inside of the lids. Hemiopia.

0 Conjunctivitis (used as a collyrium). "Weakness of eyes, as if from weariness (1)

Ears.

Shooting pain extending into the left ear, from a painful spot in the throat.

Face.

Heat of the face accompanying the nausea.

Chilly feeling in the left cheek extending to the ear.

Circumscribed redness on one cheek.

Mouth.

Taste as of corrosive sublimate.

Profuse now of clammy saliva; a tenacious mucus.

Mouth dry with white coated tongue, etc.

Throat.

Burning dryness of the throat.

Frequent hawking, from tough mucus in the throat. Prickling in the throat, with eructations and burning sensation rising up from the stomach.

• Sensation as if the oesophagus contracted itself from below

upwards.

Feeling of pressure in the whole course of the oesophagus, with

a vermicular motion, most strongly felt below the larynx and in the epigastrium. Epigastrium and a spot below the larynx are most sensitive points.

Prickling in the throat, with desire to vomit.

• Sensation as of a lump in the pit of the throat. (Lachesis.)

Appetite and Stomach.

• Loss of appetite, with acrid, burning taste in the mouth.

• Acidity of the stomach, with a constrictive feeling in the pit

of the stomach.

• Flatulent eructations, with acidity and heat of the stomach

• Incessant and violent nausea, with pain, heat and oppression

accompanying the affection of the respiratory organs. Nausea and vomiting,, with prostration of strength. Vomiting of food after eating it warm.

° Dyspepsia, heartburn and running of water from the mouth.

Paroxysms of a feeling of pressure on the pit of the stomach.

Violent, painful constriction in the cardiac region.

° Gastralgia biliosa; paroxysms of excruciating pain, and feeling as of a heavy load in stomach.

° Gastralgia simplex; the pain extends up into the chest and causes dysphagia.

• Sense of weakness and oppression at the epigastrium, with

oppression in the chest. Inflammation of the stomach and bowels. Burning pain in the stomach, toward the back, as if the part

nearest the spine was inflamed.

• Dyspepsia, with a sensation of excessive weakness at the

stomach, extending up into the chest and down to the umbilicus, always attended with oppression at the chest. {Dr. Jeanes,) (also Baptisia — Hale.)

Abdomen.

Pain in the right hypochondrium, with distension of the abdomen and shortness of breath.

Flatulent rumbling in the abdomen, with pain, worse after eating.

Sensation as if diarrhoea would occur. Griping and drawing pain in the abdomen.

e Intussusception of the bowels. (Marcy & Hunt.) ° Incarcerated hernia. (Eberle.)

Stool.

Papescent stools; whitish, soft stools.

Scraping sensation during stool, with discharge of black blood. 0 Copious hemorrhage from the hemorrhoidal vessels.

Urine.

Increased secretion of urine, or urine diminished. Sticking pain in the region of the right kidney. Urine easily decomposed, depositing a pink sediment and small brown crystals. (JYoac.)

Sexual Organs.

Male. — Aching pain in the urethra, with smarting of the prepuce.

Pressure and feeling of weight on the genital organs. Female. — Uterine hemorrhage. Violent pain in the sacrum, with fever. Supervening suppression of the menses during fever. 0 Menses suppressed, with pain in the right shoulder. ° Suppressed menses in consumptive persons. 0 Rigidity of the os and perinseum during labor.

Larynx.

Frequent, short, dry cough, from tickling in the larynx, and sensations of a foreign body in the throat, impeding breathing and swallowing.

Violent, racking cough in paroxysms, with expectoration of ropy mucus.

° Croup — spasmodic — a very efficient remedy.

° Whooping cough; bronchitis; spasmodic coughs.

Chest.

• Tightness of the chest, with laborious breathing and a sense

of oppression causing a deep breath to be taken.

• Deep inspiration relieves thepressive pain in the epigastrium.

• Short and slow inspiration, with desire to cough.

0 Chronic dyspepsia, with sensation of a lump in the pit of the

throat and oppression of the chest. ° Paroxysmal asthma, with pain in the chest. Pain in the chest from deep inspiration.

Feeling of drawing in the left breast from the nipple to the axilla.

• Angina pectoris, with pain extending to the shoulder and arms. ° Constant dyspnoea, aggravated by the slightest exertion and

increased by the shortest exposure to cold.

• Sensation of weakness and pressure on the epigastrium,

rising from thence to the heart, with or without heartburn.

• Feeling as of a lump or quantity of mucus, and also a sense

of pressure in the larynx. Weakness and oppression in the epigastrium, with oppression of the heart.

° Paroxysmal asthma, chronic, very distressing, often cured by Lobelia, and nearly always palliated. (Dose 5 to 10 drops every hour or two.)

0 Spasmodic asthma / the most aggravated attacks sometimes yield quickly to small doses of the tincture. (Jeanes.) Back.

Burning and cutting in the lower part of the spine. Rheumatic pains between the scapula, Painfulness of nape of the neck and dorsal region. Violent spasmodic pain in the posterior iliac regions.

Upper Extremities. Rheumatic feeling in the right shoulder joint. Pain only when touched, in the muscles of the right arm. Paralytic feeling in the left arm. Severe rheumatic pain in the right elbow joint.

Lower Extremities. Pressing pain in the middle part of the thigh, with constrictive feeling of the head.

• Inflammatory rheumatism of the right knee, with tearing

pains in the fibula.

Weariness of the limbs, with cramp-like feelings in the gastrocnemius.

Prickling sensations through the whole body.

Cramps in the calves.

Fever.

• Fever and ague, with chill in the middle of the day, followed

by heat and sweat, which lasts until next morning. Sensation of heat and shuddering in the daytime. 0 Intermittent fevers (quotidian).

Skin.

Eruptions between the fingers, on the dorsa of the hands and on the fore arms of small vesicles, with tingling itching.

{Teste.)

Prickling itching of the skin all over the body.

Sleep.

Restless sleep, with anxious and sad dreams.

Volume II — Special Therapeutics

Although this species of Lobelia has not attained anything like the celebrity in our school of practice that it attained in the Botanic and Eclectic schools, it is a medicine well worthy your study and investigation. Its medical history is very interesting. The early historians of New England inform us that it was considered a sacred plant by the aborigines, who used it in their great councils to clear their stomachs and heads and fit them for grave consultations and for battle.

It is interesting to know that many of the most ancient nations — Greeks and Asiatics — used certain plants for the same purpose. The plant used by the Greeks was the Veratrum album.* The remaining Indian tribes of this country all use certain emetic plants for this purpose.

An uneducated man, calling himself “ Dr.” Thomson, a native of New Hampshire, was the actual founder of that strange and ridiculous system of practice called the “ Botanic,” and although he claims to have discovered by accident the medicinal qualities of Lobelia, probably got his knowledge from the Indians who lived around him. From them he also got his practice of steaming the sick, for it is well known that this process is one very common among all Indian tribes for the cure of many diseases.

• See Hahnemann’s Thesis on the Helleborism of the Ancients, “ Lesser Writings.”

As a literary curiosity, I quote Thomson’s account of his “discovery : ”

Some time in the summer of 1790, after I was four years old, being out in the fields in search of the cows, I discovered a plant, which had a singular branch and pods, that I had never before seen, and I had the curiosity to pick some of the pods and chew them. The taste and operation produced were so remarkable that I never forgot it. I afterwards used to induce other boys to chew it, merely for sport, to see them vomit. I tried this herb in this way for nearly twenty years without knowing anything of its medicinal virtues. It had never occurred to me that it was of any value as a medicine until, when mowing in the field with a number of men one day, I cut a sprig of it and gave it to the man next to me, who ate it. When we got to the end of the piece, which was about six rods, he said he believed that what I had given him would kill him, for he never felt so before in his life. I looked at him and saw that he was in a most profuse perspiration, being as wet all over as he could be. He trembled very much and there was no more color in him than in a corpse. I told him to go to the spring and drink some water. He attempted to go, and got as far as the wall, but was unable to get over it, and laid down on the ground and vomited several times. He said that he thought he had thrown off his stomach two quarts. I then helped him into the house, and in about two hours he ate a hearty dinner; in the afternoon he was able to do a good half-day’s labor. He afterwards told me that he never had anything do him so much good in his life ; his appetite was remarkably good. He felt better than he had for a long time.

Dr. W. P. C. Barton, in his “ Medical Botany,” thus refers to the history of this drug :

The first notice I can find in print of the medical virtues of Indian tobacco is simply a brief remark by Schcepf, that the root is astringent and used in ophthalmia. He seems to have had little knowledge on the subject, and from the manner in which the plant is mentioned by him, it may reasonably be expected that a vague rumor only of its medical properties had reached him. The next accounts we hear of it as a medicine are by the Rev. Dr. Cutler and the late Professor Barton.

As Dr. Thomson was practicing in Massachusetts, it may be inferred that Cutler or his informant obtained their knowledge of its virtues from him.

It was first introduced into the regular (?) profession in 1810, by the Rev. Dr. Cutler, of Massachusetts, whose attention was directed to it by Dr. Drury, of Marblehead, who had been cured of asthma by its use. It seems Dr. Cutler was suffering from the same difficulty; he used this drug and was cured. He published his case, which attracted the attention of the profession.

It was introduced into England by a Dr. Reese.

As regards its introduction into homoeopathic practice it was first noticed in “ Jeanes’s Homoeopathic Practice of Medicine,” Philadelphia, in 1838, in which he detailed several cases of asthma and other diseases which were cured by this remedy.

But the first publication of its pathogenesis was by Dr. Alpheus Noack, of Leipsic, in his excellent treatise on the Lobelia Inflata, in the fifteenth volume of the “Hygea” (1841). This exhibits very extensive research ; he has perhaps quoted every writer of any eminence who has mentioned this plant.

The experiments of Noack were accompanied by contemporaneous thermometrical, barometrical, and meteorological observations. Among the circumstances noticed in his experiment on his own person was the speedy decomposition of the urine passed on the first day of his trial. This had taken place by the next morning, when a rose-red sediment was deposited on the sides of the vessel, in which was found a small brown urinary crystal, which under a microscope of two hundredfold magnifying power had the form and size of a large currant, and formed a granular conglomerate.

Another proving is found in the “ British Journal,” vol. xvii, page 464; also in vol. i.

The first pathogenesis was published in the first volume of the “Transactions of the American Institute.”

Notwithstanding it is claimed to be such a harmless plant by its votaries, it is capable of causing serious and fatal toxic effects.

Horses and cattle have been killed by eating it accidentally. Mr. Proctor gave a grain of Lobelina, in solution, to a cat. In less than two minutes it produced violent emesis and prostration, from which the animal recovered in three hours. Again, one grain of the substance in an ounce of water was administered directly into the stomach of the animal by an elastic tube. Immediate and total prostration was the consequence, which in half an hour rendered the animal almost motionless. The pupils of the eyes were much dilated. The animal gradually recovered its strength, but the effects of the prostration were evident for fifteen hours afterwards. No emetic or cathartic effects resulted.

Mr. Curtis and Dr. Peterson experimented with it on hedgehogs and cats. They noticed that the heart continued to beat for some time after breathing had ceased. Dissections revealed congestion of the lungs and venous system, as happens in case of death from asphyxia. The stomach and bowels were found to be in an inflammatory condition. Charles Whitelaw remarks that it causes cattle to become hidebound and affected with dandruff.

On man several deaths are recorded to have occurred from the use of this drug, both in this country and Great Britain. An inquest was held in England, in November, 1853, on the occasion of a death from Lobelia, by Dr. Letheby, Professor of Chemistry in the London Hospital. He stated that thirteen cases of poisoning had occurred from this drug within three or four preceding years. The doctor found in the stomach of a woman who had been poisoned with it, 110 grains; in the case of a man, a tablespoonful of the seeds, and in a child three years old, fifteen grains of the seeds in the bowels.

The following case of poisoning is found in volume vi of the “ Massachusetts Reports.”

A Mr. Ezra Lovett caught cold, and sent for Dr. Samuel Thomson, of Beverly, who forthwith obliged him to take three powders of Lobelia, successively, at half an hour’s interval between each. Every powder produced dreadful vomiting ; in the night long-continued and copious sweats occurred. Two similar powders given another day produced vomiting and extreme uneasiness ; and the same given the following day sunk the patient into a state of great depression.

A few days afterwards the doctor returned, and finding his patient worse, gave him some more powders of Lobelia, which at first produced great uneasiness, but latterly became wholly inoperative. Thomson supposed that the medicine would be directed to the bowels and excite purging. However, in the evening the patient lost his senses, and was attacked with convulsions, so that two men were required to hold him. Not a whit the less, however, did Thomson continue to repeat the Lobelia, and gave his unfortunate victim two powders more. The patient grew gradually worse, and at length expired. Thomson was arrested on the charge of murder, but liberated, as the sad issue of the case could not be ascribed to malice on his part.

Inflammation of the stomach and bowels have been noticed after large emetic doses.

Dr. Teste’s proving, which appeared in his “ Materia Medica,” is open to serious doubts of its trustworthiness. He says it produces an eruption similar to the itch, and he recommends Lobelia and Croton as the two grand specifics for that eruption ; but no clinical experience has ever been published to verify his recommendation.

The homoeopathic profession remember distinctly with what boldness Teste pronounced the dictum, in his “Diseases of Children,” that Lobelia was a specific in all cases of recent itch, and that Lobelia and Croton were the specific remedies for the itch. Upon the appearance of that book, which shot like a meteor across the sky of homoeopathic literature, and like an ignis fatuus, led astray those who followed its teachings, many physicians were induced to test the Lobelia in cases of scabies. What was the result ? Although fifteen years have elapsed, not a single clinical case has been published or related which proved Teste’s recommendation of any value. Teste’s recommendation, be it remembered, was based upon the supposed pathogenetic effects of Lobelia in causing itchlike vesicles in a single instance! A recommendation based on such insufficient grounds is not in accordance with the demands of our science. This is not the only instance in which Teste erred in a similar manner.

Since the appearance of his “Materia Medica” in this country, in 1854, I have carefully observed hundreds of cases of persons who were taking Lobelia, both in large and small doses, and I have never observed any eruption, coincident or subsequent, which could by any stretch of fancy be said to have been caused by that drug.

I have also made inquiries of truthful, observing physicians of other schools, who are in the habit of using Lobelia, and their testimony is decidedly against its power of producing irritation of the skin, when taken internally. Dr. P. II. Hale, who has had ample opportunity of observing its effects, states that with the intense nausea it causes, there is sometimes a priclcling-itching of the skin; acting on this hint, he thinks he has seen benefit arise from its use in suppressed urticaria, with nausea and vomiting. This, however, would not prove its homoeopath icity to any organic skin disease like itch. The intense itching caused by Opium is probably owing to its irritant action on the peripheral nerves; Lobelia causes its itching-prickling in the same manner.

For three years I used the Lobelia alone in many cases of recent itchlike eruptions, but never observed the least benefit accrue, although I followed Teste’s advice as to the potency to be administered. At one time Dr. Douglas recommended it in his lectures and writings.

Teste says he has used it successfully in a case of “papulous exanthem, evidently of a psoric origin.”

Marcy and Hunt remark :

It also operates upon the skin, curing a peculiar kind of herpes, formerly called “ James River Tetter.” It was common on that river, and cured by the Lobelia.

Lobelia has proved an antidote to Rhus tox. A lady in Massachusetts was severely poisoned. The usual allopathic remedies were applied : Lead water, Zinc, etc., but all to no purpose. The disease extended over both hands and arms, to the shoulders, and over the entire face, causing symptomatic fever and slight delirium. At 2 p.m., one drachm of the inspissated tincture of Lobelia was dissolved in one pint of water, and cloths wet in this were freely applied. At the first application the relief was marked ; the smarting subsided and the redness disappeared. The cure was completed in one-half of the usual time of spontaneous cures. In the rapidly spreading erysipelas caused by dissection wounds, Lobelia is said to have effected several marked cures. Dr. J. S. Andrews, of Massachusetts, was severely poisoned, with two other gentlemen, on opening the body of an ox dead of a malignant disease. On the third day, the two companions died, and he had symptoms of the same disease, which produced spasms and every phenomenon that occurred in the other cases. Lobelia was used as a poultice locally, and also internally by enemas and by the stomach, in very massive doses. He recovered with sloughing of the wounded parts.

In two other cases of poisoning from dissection wounds, with a dynamic fever, and a rapidly extending erysipelatous inflammation from the seat of the puncture, it was equally successful.

Let us inquire into the sphere of action of this powerful drug. The direct action of Lobelia is doubtless upon the nervous system. Its whole force seems to be spent upon this system. Selecting the pneumogastric, about opposite the pharynx, as the startingpoint, it passes in both directions, involving the phrenic, solar, and cardiac plexuses, and finally the cerebro-spinal system.

Nerves of Sensation. — This division of the nervous system is the first to note the introduction of Lobelia. That faithful sentinel, the superior laryngeal, telegraphs to the brain that a poison has invaded the system.

The pneumogastric being made up of both sensory and motor filaments, the impression passes down the extremities of that nerve, and the brain sends a motor current to eject the drug; while this is being done the sensation has gone on to the great sympathetic, and finally it is “felt at the finger ends and toes.” The sensation is felt more severely in the solar plexus. The depression upon this and the other plexuses of the sympathetic system is such that the patient imagines that death is about to ensue.

The “ healthy” feeling expressed by patients who have taken this drug, is due to the reaction. It is like the exultation of joy following the depression of fear.

I think this starting-point of attack is the key to the use of the drug.

Nerves of Motion. — This system is brought most powerfully under the action of this drug. The inferior laryngeal seems to be the first one called into action, which causes a constricted feeling at the larynx ; passing over the oesophagus, contracts its whole length, then the stomach contracts from below upwards, and emesis follows ; in the meantime the bronchi and breast contract, and the patient feels as if suffocation was impending. Now the voluntary muscles are called into action, and if the drug is carried far enough, convulsions and death ensue.

Muscular System. — As we have already seen, this system suffers severely, the whole nervous energies being brought so completely under control of this drug.

The involuntary muscular fibres are the ones first involved, as we observe by the vermicular motion of the muscular fibres of the oesophagus, the contractions of the stomach and bronchi, and the lowered action of the heart.

Want of power in the sphincter ani was cured in one case. (See last case under “ Stomach.”)

The voluntary muscles do not seem to be affected until the involuntary are completely under its influence.

In the reduction of luxations the eclectics use it much as we do

Chloroform to relax the muscular fibres, until the patient is as “limber as a rag.” This is why it is of service in rigidity of the os, rigidity of the perinseum, intestinal intussusception, and in hernim. It is not homoeopathic to any such condition any more than is the vapor-bath.

The nerves of the heart are affected in the same manner as by Tobacco. Its primary effect is to paralyze, the secondary to cause spasms and pain. This shows why it is useful in certain cases of faintness (in a high dilution), and in spasmodic palpitations and, angina pectoris (in low dilutions).

The nerves of the stomach are certainly most seriously affected by the specific action of the drug. I have frequently used it in spasmodic cardialgia, in bilious gastralgia , and even in the terrible pain caused by the attempted passage of gall-stones. In each of these disorders it should be used in the lower dilutions.

It is certainly homoeopathic to vomiting with great prostration, cold sweat, feeble pulse, etc., but the records of our school show but few cases reported. It should be used high in such cases.

I believe it will prove as useful in the vomiting from fright and other emotions, in nervous subjects, as Gelseminum is in diarrhoea (involuntary generally) from similar causes.

Dr. Jeanes, one of the original investigators of the Lobelia, in our school, remarks he has been able to remove many dyspeptic symptoms with this drug. He considers the chief indications for its use are : A sense of weakness and, oppression at the epigastrium , and at the same time some oppression at the breast. The nearer approach to these symptoms the less have I been disappointed. There are, however, some cases where although the symptoms of pectoral oppression are very trifling, yet this remedy operates satisfactorily. In a case of this kind, which I have but recently treated, and which occurred in a fat, robust man, about forty-five years of age, who complained chiefly of a copious haemorrhoidal discharge, and consequent debility, and a sensation of tightness in the epigastrium with some acidity of the stomach, I at first gave him Nux vomica without any apparent abatement of his disease, and subsequently]}^ some other remedies with the same want of success. At length he complained of some oppression at the breast, for which I administered Lobelia §. The following day he informed me

that he felt new life and vigor, and that the pectoral, gastric, and haemorrhoidal disorders had all disappeared since that time, now about two weeks ; he has remained free from them, and also from a feeling of want of power in the anus and rectum, which was exceedingly uncomfortable to him while at stool, and to which he had been subject for many years.

The Lobelia does not have that debilitating action on the stomach, as an immediate effect, which other emetics cause. Most persons, after an emetic of Lobelia, can eat heartily and with relish. Its long-continued use, however, debilitates the stomach and weakens digestion. “Botanic” physicians consider it one of the best remedies for dyspepsia. They insist that small doses, five or six drops, one hour before meals, largely increase the appetite and power of digestion ; but if the patient be bilious, an emetic dose must be given.

I have found it most useful in the dyspepsia due to excessive use of green tea, tobacco, and bad liquor. In such patients you will always find the faintness at the stomach a prominent symptom. If you consult the gastric and stomach symptoms of Lobelia, you will find quite an array of peculiar symptoms.

The following are the chief symptoms, according to Dr. Jeanes, which indicate the use of Lobelia:

Constant dyspnoea, aggravated by the slightest exertion, and increased by even the shortest exposure to cold, to an asthmatic paroxysm ; sensation of weakness, and pressure on the epigastrium, rising from thence to the heart, with or without heartburn ; feeling as of a lump or quantity of mucus, and also a sense of pressure in the larynx ; pain in the forehead from one temple to the other ; pain in the neck ; pain in the left side ; high-colored urine ; weakness and oppression in the epigastrium, with simultaneous oppression of the heart.

Dr. Cutler (allopath) gives his case as follows :

It has been my misfortune to be an asthmatic for about ten years. I have made trial of a great variety of the usual remedies, with very little benefit. In several paroxysms I had found immediate relief, more frequently than from anything else, from the skunk cabbage. (Dracontium foetidum, Lin.; Arum Americanum, Catesby.)

The last summer I had the severest attack ever experienced. It commenced early in August and continued about eight weeks. Dr. Drury, of Marblehead, also an asthmatic, had made use of the Indian tobacco, by the advice of a friend.

in a severe paroxysm early in the spring. It gave him immediate relief, and he has been entirely free from the complaint from that time. I had a tincture made of the fresh plant, and took care to have the spirit fully saturated, which I think is important. In a paroxysm which perhaps was as severe as I ever experienced, the difficulty of breathing extreme, and after it had continued for a considerable time I took a tablespoonful. In three or four minutes my breathing was as free as it ever was, but I felt no nausea at the stomach. In ten minutes I took another spoonful, which occasioned sickness. After ten minutes I took the third, which produced sensible effects upon the coats of the stomach, and a very little puking, and a kind of pricking sensation through the whole system, even to the extremities of the fingers and toes. The urinary passage was perceptibly affected by producing a smarting sensation in passing urine, which was provoked by stimulus upon the bladder. But all these sensations very soon subsided, and vigor seemed to be restored to the constitution, which I had not experienced for years. I have not since had a paroxysm, and only a few times some small symptoms of asthma. Besides the violent attacks, I had scarcely passed a night without more or less of it, and often so as not to be able to be in bed. Since that time I have enjoyed

as good health as, perhaps, before the first attack . In all cases of

which I have been informed, it has produced immediate relief, but the effects have been different in different kinds of asthma. Some have been severely puked with only a teaspoonful, but in all cases some nausea seems to be necessary. The asthma with which I have been afflicted, I conceive to be that kind which Dr. Bree, in his practical inquiries on disordered respiration, etc., calls the first species, a convulsive asthma from pulmonic irritation of effused serum. My constitution has been free, I believe, from any other disorder than what has been occasioned by an affection of the lungs, anxiety of the praecordia, and straitness of the breast, and other symptoms, produced by that affection.

Although Lobelia produces a kind of dyspnoea by its primary effect, it is not true asthma, but rather a difficulty of breathing from faintness and sinking at the stomach. The dyspnoea seems to come from the stomach, and not from thoracic or bronchial con-

, , i ;

stnction.

The asthma which Lobelia has attained such a reputation in, is a purely spasmodic affection of the motor nerves which supply the bronchi, the larynx, and other portions of the respiratory apparatus.

It is a secondary effect of Lobelia, to cause just such a condition of the nerves of motion, as we find in the severer cases of asthma.

If anything was wanting to prove this theory, it is the fact that appreciable doses are required to palliate or cure the affection.

You may be able to relieve a primary dyspnoea like the one I just mentioned, with the sixth or twelfth dilution; but to relieve

a true asthma you will have to resort to the mother tincture or the first decimal dilution.

I have found that it is not necessary to vomit the patient in any case; nor is it necessary in all cases to cause nausea; and the majority of cases can be relieved without nausea. Begin with a single drop, and increase a drop every dose (repeated every fifteen or twenty minutes in bad cases) until the patient begins to breathe easy ; then decrease the dose in the same manner.

In spasmodic croup, asthma of Millar, and other spasmodic affections of the throat, even in spasms of the larynx of hysterical patients, Lobelia is a remedy upon which you can generally rely.

In the country, and often in the city, it is always kept in the houses of the people, who look upon it as a panacea in all cases of croup. They give it on the first appearance of the stridulous breathing, ringing cough, and dyspnoea. These symptoms it always relieves, and if the attack is spasmodic it cures. But if it be catarrhal, or pseudo-membranous, it palliates only; and in the latter affection it does positive injury by depressing the vital forces, for it has no specific power over any inflammatory process involving the organs of respiration.

In domestic practice it is given in all kinds of doses, from a drop to a teaspoonful.

As a good illustration of the specific action of Lobelia in spasm of the larynx, I give a case reported by Dr. Knowles, of Avoca, Iowa :

A young woman, after washing nearly all one cool day, exposed to sudden alternations of temperature, was seized suddenly with a paroxysm of coughing and choking. The constrictive sensation seemed to be in the locality of the larynx. In half an hour after the beginning of the seizure, the woman seemed to be dying, the dyspncea was so terrible. A constant cough tormented her all this time.

When I first saw her, about an hour after her seizure, she was gasping for breath, her face livid, and expressing the greatest anxiety. There was apparently but a few seconds’ interval between the paroxysms. She could speak but a word or two at a time, and could swallow only at rare intervals.

Any one who has ever witnessed a case of this distressing disorder, in an adult or child, has witnessed a scene of the most frightful suffering known, aggravated with an intense fear of death.

In this case ten drops of the 2X dilution was repeated every five or ten minutes, as I could get her to swallow it. She was relieved after the third dose, and had no spasm after the fourth.

This may be considered a rapid and brilliant cure; but such cures are often made with Lobelia.

In homoeopathic practice, the effectual dose for croup will lie between a few drops of the tincture and a few drops of the second decimal dilution.

In diseases of the organs of generation of women it has not been used except in cases of labor, but the discovery of Ether has superseded its use in most cases. You may, however, find it of value in certain rigid or spasmodic conditions. Many country practitioners of our school value it very highly in slow or difficult labors from want of relaxation. Dr. Paine (eclectic) uses it to allay those skirmishing pains before parturition ; to ward off threatening convulsions in approaching eclampsia . Where the old school resort to the lancet he uses an enema of Lobelia with happy results.

It is of much use in rigidity of the os, which often exists to the great annoyance of busy practitioners. The same dose (5j or 5ij, by enema) is here given, which not only relaxes the rigid os, but all the muscles of the body.

Rigidity of the Perinceuru. — Often, says Paine, have I had to bring my instruments to deliver a patient (and the doctor, too) where this condition of affairs, the head thrust against the perinseum, had existed for hours, the attending physician using teas, fomentations, and patience without avail. A single enema of Lobelia has worked like a charm, relaxing the parts, and the child was born.

It is doubtful if Lobelia is primarily homoeopathic to any of the above conditions, excepting, perhaps, the false pains before parturition.

The tincture in drop doses or more will have to be used.

You may have occasion to use the Lobelia in certain obstinate and annoying cases of convulsions. I allude to the hysterical convulsion. In the great majority of cases no attenuated remedy will arrest the paroxysm. The cure of hysteria must consist of a constitutional treatment for the removal of a cause. But the treatment of the paroxysm must be “ short, sharp, and decisive.” If a firm, decided, and imperative command does not arrest it, do not allow yourself to be kept by the bedside, hour after hour, as you

will be importuned to, but immediately give Ether, Chloroform, Chloral, or Lobelia. A teaspoonful of Lobelia has a magical effect in such cases. The nausea or vomiting, with its consequent relaxation, arrests the most violent hysterical spasm. If you cannot get her to swallow it, give it in an enema.

It is, however, homoeopathic to many of the premonitory symptoms of hysteria, especially the anomalous sensations in the throat or oesophagus, the “ globus hystericus,” etc. I have often relieved such symptoms with attenuated doses.

Dr. Scudder, although in the eclectic school, is as good a homoeopathist as the most of us, gives the following as his experience with Lobelia :

Recognizing the fact that it primarily causes great cardiae depression, he declares that in small doses it is a cardiac stimulant.

He says it is indicated in nearly all diseases where we find “ prcecor dial oppression, with enfeebled circulation ; a feeble, empty, oppressed, 1 doughy ’ pulse ; ” a “ fulness of tissue, with loss of elasticity or precisely such a condition as Lobelia causes when taken in large doses.

In asthma, angina pectoris, cardiac neuralgia, uterine catarrh (with swollen, flabby uterus), agues, and many other diseases, he finds Lobelia to be specific, if the above characteristic indications are present.

This is the true doctrine, and Dr. Scudder has hit the keynote of the remedy. His doses are rather large (five to twenty drops every hour or two), but he gives many cases illustrating the prompt curative action of such doses, without causing any “aggravations.” Perhaps the same doses of the lx or 21 dilutions would have done as well ; but the size of the dose is a minor matter, provided the medicine cures.