Plumbum. (Plumbum Metallicum.)

Lead ; the Metal, the Acetate and Carbonate.

Introduced by Hartlaub.

Provings and toxicological reports are numerous. See Allen's Encyclopædia, vol. 8, p. 1 .

CLINICAL AUTHORITIES.

• Mental disturbance , Chapman, B. J. H., vol. 3, p. 170 ; Hypopion , Theuerkauf, Rück. Kl. Erf., vol. 5, p. 118 ; Affection of eye , Woodyatt, Organon, vol. 1, p. 483 ; Erysipelatous inflammation of nose , Rosenberg, Rück. Kl. Erf., vol. 5, p. 173 ; Stricture of œsophagus , Sommer, Rück. Kl. Erf., vol. 5, p. 249 ; Gastralgia , Bute, Rück. Kl. Erf., vol. 1, p. 657 ; Cardialgia , Kunkel, A. H. Z., vol. 106, p. 189 ; Lilienthal, Hom. Cl., vol. 3, p. 43 ; Affections of stomach , Gross, Rück. Kl. Erf., vol. 1, p. 656 ; Kunkel, A. H. Z., vol. 102, p. 172 ; Jaundice , Guernsey, Hah. Mo., vol. 5, p. 238 ; Colic, Müller, Lorenz, Rück. Kl. Erf., vol. 5, p. 370 ; Hesse, A. H. Z., vol. 111, p. 43 ; Holland, B. J. H., vol. 32, p. 79 ; Miserere , Lorbacher, M. A. J. H., vol. 4, p. 340 ; Enteralgia , Hughes, B. J. H., vol. 22, p. 239 ; Intussusceptio , Lorbacher, Theuerkauf, Rück. Kl. Erf., vol. 5, pp. 375, 383 ; Tumor cæci , Marcy, N. A. J. H., vol. 4, p. 343 ; Impaction of feces , Lorbacher, B. J. H., vol. 29, p. 611 ; Hernia , Baumann, Raue's Rec. 1873, p. 127, from A. H. Z., vol. 85, p. 11 ; Incarcerated hernia , Baumann, B. J. H., vol. 31, p. 24 ; Diarrhœa , Fanning, Hom. Cl., vol. 2, p. 193 ; Cholera , Henke, Kurtz, Rück. Kl. Erf., vol. 1, p. 95 ; Gerstl, Rück. Kl. Erf., vol. 5, p. 482 ; Constipation , Hartlaub, Rück. Kl. Erf., vol. 1, p. 818 ; Dixon, B. J. H., vol. 28, p. 390 ; Dudgeon, B. J. H., vol. 29, p. 612 ; Dake, Organon, vol. 3, p. 355 ; C. D. F., Organon, vol. 3, p. 363 ; Spasms of rectum , Chapmann, B. J. H., vol. 3, p. 173 ; Cirrhotic kidney , Gatchell, Times Ret., 1877, p. 38, from A. O., vol. 1, p. 235 ; Jones, A. H. O., vol. 12, p. 561 ; Desquamative nephritis , Weil, A. H. Z., vol. 103, p. 131 ; Strangury , Brener, A. H. Z., vol. 107, p. 99 ; Ovarian dropsy , Young, Times Ret., 1875, p. 93 ; Metrorrhagia , Griessel, Rück. Kl. Erf., vol. 2, p. 322 ; Hæmoptysis , Hartmann, Rück. Kl. Erf., vol. 3, p. 222 ; Phthisis , Trinks, Rück. Kl. Erf., vol. 3, p. 390 ; Schleicher, Rück. Kl. Erf., vol. 5, p. 843 ; Weakness and paralysis of extensor muscles of fingers , Chalmers, Hom. Rev., vol. 13, p. 145 ; Nervous affection of leg , Russell, B. J. H., vol. 14, p. 376 ; Sciatica , Garay, Rück. Kl. Erf., vol. 5, p. 902 ; Offensive foot-sweat , Lilienthal, N. A. J. H., vol. 14, p. 137 ; Rück. Kl. Erf., vol. 3, p. 592 ; Chorea , Peters, N. A. J. H., vol. 3, p. 144 ; Epilepsy , Tietzer, Rück. Kl. Erf., vol. 4, p. 589 ; Burnett, Hom. Rev., vol. 22, p. 20 ; Brown, Hom. Rev., vol. 22, p. 267 ; Paralysis , Hahnemann, Munnecke, Rück. Kl. Erf., vol. 4, p. 475 ; Kunkel, A. H. Z., vol. 102, p. 173 ; Paraplegia , Martin, T. H. M., S. Pa., 1885, p. 200 ; Chlorosis , Winter, Rück. Kl. Erf., vol. 2, p. 275 ; Winter, B. J. H., vol. 3, p. 218 ; Lead poisoning , Griffin, Times Ret., 1875, p. 160.

MIND [1]

Weakness or loss of memory ; unable to find the proper word.

Slow of perception ; intellectual torpor ; gradually increasing apathy.

Anxiety, with restlessness and yawning.

Gloom alternates with excitement.

Much depression of spirits, especially with colic.

Quiet and melancholic mood.

Indifference and somnolence, with lamentations about difficulty of breathing and headache.

Deep melancholy, with timidity and restlessness ; anxiety at heart, with sighing and trembling ; dislikes to talk or work ; maniacal rage, with cries and convulsions ; absence of mind ; stupidity ; pale, miserable, cachectic appearance ; somnolency ; colic.

Wild delirium with distorted countenance.

Delirium, alternating with colic ; bites and strikes at those near him ; tremor of head and hands ; yellow mucus collects about mouth and teeth.

Delirium furious at night, milder by day, with hallucinations and sleeplessness at night and sopor by day ; tremulousness mostly in head and hands ; face red or straw-colored, with mucus in mouth, black teeth, fetid odor ; grinds teeth ; eyes swollen, or look is suddenly changed, as if frightened ; throws off bedclothes ; loss of all senses ; delirium increases as senses diminish ; puffing of cheeks, especially if paralysis is a sequel or is caused by suppressed colic, with bloated abdomen.

Sudden fainting on going from one room to another full of company, with screams, fright without cause, spasms in muscles of face, but mind remains sound.

Thought his life was in danger from assassination or poison and that every one about him was a murderer.

Insomnia, severe headache, occipital or frontal, with or without vertigo ; noises in ears ; disordered vision ; diplopia ; amaurosis ; contraction of pharynx, though liquids are swallowed in gulps and greedily ; mind weak, morose and sad ; preceded by albuminous urine.

Great depression of spirits ; though habitually very temperate had recourse to various stimulants, at first in moderation and openly, but soon immoderately and by stealth ; sleeplessness ; gloom ; despair of her salvation ; moody taciturnity ; fixed idea that she could only obtain peace and safety through absolution from a priest of the Papal Church, although she had been a zealous Protestant ; face nearly of a leaden hue ; perpetual movement of lips, as of one smoking, accompanied by a slight sound ; very silent, but when spoken to answered rationally ; severe pain, starting up from back into head, as if something were working at top of head, with a sense of screwing from behind forward ; some flatulence ; frequent drowsiness by day, sleeplessness by night ; profound melancholy and frequent sighs ; brooded over any forbidden thing ; would steal from house in servant's cloak and bonnet to obtain stimulants, but from the moment their prohibition was withdrawn ceased to have any desire for them ; after being permitted to visit a priest and converse with him ceased to talk and think of the Church.

Mental disturbance of eight or ten years' duration in a man addicted to masturbation ; has several times attempted suicide ; has been in seclusion ; greatest dejection and despair ; fixed, moody look, with a constant scowl ; believes himself lost ; has the sounds of hell constantly in his ears ; hears voices and sees shadows of demons ; great disposition to make away with himself, or do himself some bodily injury ; gloom and taciturnity alternate with frantic delirium ; drowsy sometimes in day, sleepless at night ; constant pain and weight in upper part of neck and back of head ; complexion dark ; violent palpitation of heart, < after eating and lying on left side ; pulse weak ; bowels regular but evacuations very dark ; seminal emissions very frequent, often occurring during stool ; testes wasted ; spasmodic stricture ; goose-skin.

Affections more of the emotions than the intellect.

SENSORIUM [2]

Sopor after spasms ; coma ; stertorous breathing, with jaws fixed ; motion with mouth as if smoking ; puffing of cheeks.

Apoplexy ; consciousness blunted ; memory deficient ; speech impeded, single syllables are omitted or cannot be combined into words ; mimic spasms of face while speaking ; trembling of tongue when put out ; semi-paralysis of buccinator muscles and of velum palatinum manifested by violent snoring ; sleeplessness ; fear of death ; organs of sense torpid and insensible ; eyes principally affected ; eyelids droop as if paralyzed ; pupils constantly dilated ; all objects seem smaller and farther removed from focus of vision, they may be seen as through a gauze ; diplopia ; pulse always slow, 50 to 60, sometimes hard and tense like wire ; all the muscles may be paralyzed, especially of left side ; paralysis affects equally motor and sentient nerves, is often attended with violent pains in paralyzed parts and considerable contractions, especially of extensor muscles, which feel as hard as wood ; in other cases spasms are tonic, and in they reach their full development run into complete epileptic convulsions ; muscles of affected parts become atrophied ; if paralysis is not complete gait is unsteady, with particular tendency to fall forward ; paralyzed respiratory muscles often occasion a high degree of dyspnœa ; sphincters scarcely ever paralyzed.

Stupefaction of head ; he falls down unconscious.

Stupefaction with somnolence.

Vertigo : on stooping ; when looking upward ; > in open air ; epileptic.

INNER HEAD [3]

Heaviness in head, especially in cerebellum.

Headache : violent ; frontal ; pulling and pressive, chronic in forehead, < from mental labor and intolerable in large company ; in temples, < in right ; as if a ball were rising from throat into brain ; with vomiting and violent pains in umbilical region.

Sick-headache, with pain in occiput, umbilical colic and bilious vomiting ; yellow skin, especially of face.

Chronic dull headaches, with depressed spirits and constipation.

Congestion of blood to head, with heat and beating in it.

Paralysis occurring early ; cerebro-spinal meningitis.

Meningitis, chronic, when paralyzed parts soon fall away in flesh ; limbs become painfully contracted ; frequent spells of colic with retraction of abdomen.

Cerebro-spinal meningitis, with early paralysis.

Chronic encephalitis and myelitis.

Sclerosis of brain, or progressive muscular atrophy, alternating with colic and constipation.

OUTER HEAD [4]

Violent pains in integuments of skull, from occiput to forehead.

Great dryness of hair, it falls off even in beard and eyebrows.

SIGHT AND EYES [5]

Diplopia.

Cloudiness before eyes, inducing one to rest them.

Dimness of vision, especially on right side ; sudden loss of sight or transient amaurosis and deafness complicating motor palsy in some cases.

Neuritis optici ; papillæ swollen (examination after death showed interstitial hyperplasia of connective tissue ; sheaths of optic nerves were distended by fluid ; cerebro-spinal fluid was greatly increased ; brain substance anemic and the gray portion yellowish).

Ophthalmoscopic examination between the paroxysms showed that the disk was prominent, its outline hazy, its color an opaque bluish-white.

Left eye affected for two weeks, badly for five or six days ; drooping upper lid ; intense photophobia ; very profuse, hot lachrymation, pericorneal injection, deep bluish-red, marked at corneal margin and fading off towards reflexial fold of conjunctiva ; slight redness of conjunctiva of lid, cornea very delicately hazy through-out its entire extent, as if breathed upon so as to dim its lustre ; and at lower inner quadrant opacity was a little denser and seemed as if it might develop into na ulcer ; cornea not normally sensitive to touch ; pupil contracted ; vision impaired ; tension of eyeball diminished ; neuralgic pains in and around eye, < at night ; atropine only partially dilated iris.

Pupils contracted or dilated.

Hypopion after iritis, extending up nearly to centre of cornea ; nightly tearing pains in eye and forehead ; could hardly distinguish day from night.

Eyeball feels too large.

Ophthalmia, lachrymation, photophobia, redness of whole ball.

Inflammation, varicose distension of vessels of cornea, obscuring light.

Passive congestion, with soft large granulations.

Yellowness of whites of eyes.

Lids spasmodically contracted.

Paralysis of upper lids.

HEARING AND EARS [6]

Hardness of hearing ; often sudden deafness.

Buzzing in ears.

Hears music ; with frightful delirium.

Stitches and tearing in ears.

SMELL AND NOSE [7]

Smell too sensitive or too feeble ; even total loss of smell.

Loss of smell with epilepsy.

Fetid odor before nose.

Much tough mucus in nose, which can only be discharged through posterior nares.

Cold nose.

Puffiness of nose.

Erysipelatous inflammation of nose, mostly in alæ nasi, with redness and vesicles discharging a thick pus when slightly pressed.

UPPER FACE [8]

Face expressive of extreme anxiety and suffering ; pale, ash-colored ; yellow, corpse-like ; bloated ; cheeks sunken.

Sallow complexion ; discolored sclerotic.

Swelling of one side of face.

Skin of face greasy, shining.

Vesicles on face and nose.

LOWER FACE [9]

Violent loud motion of lower jaw and frightful grinding of teeth.

Lockjaw.

Tearing in jaws relieved by rubbing them.

Lips peel off without pain or dryness.

Swelling of submaxillary and sublingual glands.

TEETH AND GUMS [10]

Grinding of teeth.

Teeth become black.

Yellow mucus on teeth.

Teeth hollow, decayed, crumbling, smelling offensively.

Distinct blue line along margin of gums.

Gums : pale ; swollen ; show a lead-colored line ; blue, purple, or brown ; painful, with hard tubercles.

TASTE, SPEECH, TONGUE [11]

Taste : sweetish ; metallic ; bitter.

Cannot put out his tongue.

Tongue : dry, brown, cracked ; coated yellow or green ; dry, red, glazed, in chronic gastritis ; dry and white (colic) ; red at edge ; brown far down centre ; inflamed, swollen ; heavy, paralyzed ; hurts as if bitten.

INNER MOUTH [12]

Saturnine breath.

Breath fetid.

Dryness of mouth.

Accumulation of sweetish saliva in mouth.

Froth in mouth.

A yellowish mucus in mouth and on teeth.

Saliva increased ; of a bluish color.

Salivation, with painful tongue and lips ; fetid smell and languor (after abuse of mercury), with yellow purple ulcers on tip of tongue and mouth.

Salivation (mercurial) so profuse in damp weather as to saturate pillow.

Aphthæ : dirty looking ulcers and purple blotches in mouth and on tip of tongue.

Ulcers in mouth, with fetid smell ; they turn yellow.

PALATE AND THROAT [13]

Constriction in throat when trying to swallow, with great urging to do so.

Sensation of a plug in throat ; globus hystericus.

Difficult swallowing.

Fluids can be swallowed, but solids come back into mouth ; burning in œsophagus and stomach some hours after eating. θ Stricture from spasm.

Paralysis of throat with inability to swallow.

Tonsils : swollen ; inflamed, covered with small, painful abscesses.

Tonsillitis : going from left to right, with yellow granulous or follicular ulcers ; small and very painful, with burning, stinging pains.

Tough mucus in fauces and posterior nares.

Angina granulosa, going from left to right.

Angina on left side, with copious flow of purplish saliva and spasms.

Diphtheria, with tendency to sloughing and implication of larynx (also Plumb. iod.).

APPETITE, THIRST. DESIRES, AVERSIONS [14]

Great hunger or complete loss of appetite.

Violent thirst, especially for cold water.

Desire : for cakes ; rye bread ; tobacco.

HICCOUGH, BELCHING, NAUSEA AND VOMITING [16]

Nausea and Vomiting.

Eructations : empty ; sweetish ; of offensive odor ; sour.

Gulping up of sweetish water.

Nausea : frequent ; constant ; occasional, sometimes followed by vomiting of food.

Vomiting : most distressing ; stomach rejecting almost everything ; of food ; constant, of everything taken ; in the night, especially early morning ; spasmodic ; with violent cardialgia ; violent of sweetish, sour, or bitter substance, like white of egg, in chronic gastritis ; of grass green substance, afterwards changing to retching ; of a brownish liquid, streaked with blood ; of food and of discolored substances, with violent colic ; of food, in morning, with great weakness ; of greenish and blackish substances ; of a blackish substance ; stercoraceous.

Vomited matter has a fecal odor.

SCROBICULUM AND STOMACH [17]

Feeling as if a ball ascend from epigastrium along thorax to throat, where it causes a kind of suffocation ; at such times can neither speak nor swallow, and suffers the greatest anxiety.

Contraction in œsophagus and stomach ; fluids can be swallowed, but solids return ; some hours after eating a burning in stomach and œsophagus ; constipation ; prostration ; emaciation.

Heaviness as from a load in stomach, with heaviness in occiput.

Pressure and tightness about stomach.

Severe pain in stomach, radiating to both groins, down both legs, particularly left.

Violent pressure in stomach and pain in back ; at times > bending backward, at others bending forward ; > from hard pressure.

Pressure in stomach, as from a heavy weight, increasing to a strangling sensation during the severe colicky paroxysms and followed by sour and bilious vomiting ; loss of appetite ; excessive thirst ; pains in back > sometimes bending forward, sometimes backward ; constipation, hard, knobby stool once a week ; taste always sweetish ; abdomen compressed hard, like a board ; constriction of throat ; paralytic weakness in extremities, especially on right side ; hands and feet cold ; total and striking want of perspiration ; paroxysms increase in severity and duration and she is already atrophied and anemic. θ Cardialgia.

Constant pressure in epigastrium ; severe constricting pain after eating heavy food ; rolls about the floor in extremity of pain ; attack lasts from ten to twelve hours, at times longer ; slight relief when lying down ; at times has terrible pains when rising in morning and when stomach is empty ; epigastrium hard and swollen during paroxysm ; < belching and at night ; feces scanty, knotty, hard as a stone, evacuated with difficulty ; at times sweetish taste.

Periodical pressing, burning and sensation of heaviness in epigastrium, as if everything were weighted down, with general indisposition ; whole abdomen felt tense and rough to touch ; stool hard, knotty ; frequent attacks of shortness of breath without cause ; offensive foot sweat since childhood ; debility ; emaciation ; profuse night sweats.

Sudden severe pains in epigastrium, compelling her to bend backward and press something hard against abdomen for relief ; < from motion ; > from belching ; after every attack eyes are deeply jaundiced. θ Gastralgia.

HYPOCHONDRIA [18]

Hepatic region sensitive to pressure.

Sensation of heat and burning in liver and spine.

Persistent sticking pain in hepatic region, first anteriorly, then posteriorly.

Continued darting pain in region of liver.

Weak and exhausted ; skin and white of eyes yellow ; urine very yellow ; stools light in color ; much nausea, particularly in evening or at night, when she vomits her food ; restless, sleep broken at night ; not able to leave her bed. θ Plumbum.

Icterus : skin and sclerotica yellow ; yellow ulcers in mouth ; sweetish risings ; abdomen bloated ; colic ; stinging in region of liver, > from rubbing.

Cirrhosis of liver ; first enlarged then contracted.

Spleen enlarged.

ABDOMEN AND LOINS [19]

A sensation in abdomen at night in bed, which causes her to stretch violently for hours together ; feels that she must stretch in every direction ; the will to do so alone cannot accomplish it ; as if from paralysis ; irritation of sentient nerves.

Borborygmi ; rumbling in abdomen.

Drawing pain from abdomen to back.

Severe colic, contracted abdomen ; bends backward ; motor nerves most affected.

Abdomen retracted ; hard, painful ; pain commenced at umbilicus and radiated to lumbar region and to iliac fossa ; rolled upon ground and pressed abdomen with violence.

Navel seems to adhere to spine and the pain also involves pectoral region.

Sensation as if abdominal walls were pulled inward ; as if abdomen and back were too close together.

Severe pains in abdomen, especially around navel, as if bowels were twisted.

Excruciating tearing pains in all the bowels, but < at navel.

Lacerating pains at umbilicus and epigastrium.

Intense retraction of the integuments of abdomen towards spine, and a hard, knotty feeling of the muscles in various places over its surface.

Extremely violent pains in umbilical region, shooting to other portions of abdomen, somewhat > by pressure ; at times they became so violent that he was almost wild, tossed about, pressed fists into abdomen and declared he must go to stool immediately.

Pain often extended to other regions, to chest, threatening suffocation, to small of back, kidneys, bladder and lower extremities.

Excessive pain in abdomen, radiating thence to all parts of body.

Violent colic ; abdomen drawn in, as if by a string, to spine ; cutting, contractive pains with restless tossing ; > from rubbing or hard pressure ; abdomen hard as a stone ; knots in recti muscles ; anxious, with cold sweat and deathly faintness.

Constriction of intestines ; navel and anus violently retracted.

Pain above umbilicus, coming on every forenoon, accompanied by vomiting. θ Enteralgia.

Severe paroxysmal pains in right side of abdomen, compelling him to bend double, > from pressure of hand, < at night, causing sleeplessness ; abdomen slightly bloated ; whole right side sensitive to pressure ; stool every second or third day.

Extremely severe pains in abdomen, recurring periodically, with spasmodic contraction of abdomen and obstinate constipation ; hard, knotty elevations here and there over abdomen ; intestines as if constricted ; pains and cramping of limbs.

Colic, with hard abdomen, great sensitiveness, relief only obtained by bending body forward and drawing up knees ; obstinate constipation ; abdominal walls retracted.

Abdomen hard as a stone ; not very tympanitic ; recti muscles drawn into knots nearly as large as a fist ; no alvine evacuation for two days, and no urine for eighteen hours ; countenance expressive of greatest anxiety ; face and forehead bedewed with cold, clammy perspiration ; pulse feeble, not very quick ; during spasms (every three minutes) vomiting of a blackish, grumous fluid ; deathly faintness ; body bending backward, so as to form a semicircle, and so sudden as to throw him from bed ; pressure from flat hand gave some relief.

Colicky pains proceeding from spinal cord, with sensation as of drawing in of abdomen to back, with great depression of spirits.

Suffering expression of face ; pulse small and frequent ; forehead and limbs cold, covered with clammy sweat ; constant belching of offensive odor and at times vomiting of fecal-like masses ; tearing, burning pains in abdomen, which seem to concentrate around umbilicus ; < from touch, motion, and particularly vomiting, which is caused by drinking slightest quantity of water ; abdomen bloated ; intestines distended with gas, so that they could be traced by finger ; extremely sensitive swelling as large as fist, on left side of umbilicus ; great thirst ; stool absent.

Colic, accompanied on third day by vomiting of ascarides ; next day continuous hiccough and offensive belching, with retching, followed at once by vomiting on drinking water ; tongue coated ; foul taste in mouth ; dryness of mouth without thirst ; anorexia ; no fever ; pressing, burning and tearing in abdomen, which was distended ; around umbilicus spot as large as fist, sensitive to pressure, from whence the pains, mostly periodical, originated ; intestines as if distended with wind, so that course of each could be felt ; constant borborygmus ; constipation of four days' duration, with frequent ineffectual urging to stool ; two days later fecal vomiting ; belching of wind of fecal odor. θ Intussusception.

Distension and hardness of cecum and ascending colon, whole region swollen, painful to touch, on motion ; tongue dry ; brown in centre ; skin hot and dry ; much thirst ; nervousness ; headache ; general depression ; expression anxious ; feeling of lameness in lower extremities ; sour eructations ; nausea ; inclination to vomit ; umbilicus retracted. θ Tumor cecum.

Large, hard swelling in ileo-cecal region ; painful to touch and motion. θ Typhlitis.

Sensation as if an abscess were forming near umbilicus ; abdominal walls hard and contracted, knotted in certain points. θ Rheumatism of bowels.

Excruciating colic from poisoning with carbonate of lead.

Colic, with paralysis of lower extremities.

Inflammation, ulceration and gangrene of bowels.

Incarcerated hernia.

Intussusception, with colic and fecal vomiting.

Strangulated femoral hernia, left side ; severe pain ; continual vomiting of feculent matter.

Strangulated scrotal hernia, right side.

STOOLS AND RECTUM [20]

Diarrhœa : violent ; painful ; fetid ; yellow ; bloody, watery, with vomiting and violent colic.

Dysentery : with violent colic ; in violent cases with bloody masses of exudation ; violent fever, cutting in stomach and bowels, burning in anus during discharge and long-lasting tenesmus ; spasm of sphincter ani as if drawn in ; burning in rectum and perineum.

Cholera, severe cases, particularly with spasms of abdominal muscles.

Stools : dark, offensive, watery ; yellow ; mucous and bloody ; bloody ; profuse, watery ; involuntary ; fetid, yellow and fecal ; watery, with vomiting and violent colic ; bloody masses.

Stool only once in eight or ten days, of scanty, blackish feces ; expulsion of which caused acute suffering.

Constipated stools : hard, lumpy, like sheep's dung ; with urging and terrible pain from constriction or spasm of anus ; knotty, feces in form or balls, often hard, black or green ; nearly always of a dark color ; ball-shaped, hard as a stone ; small, hard balls covered with greasy pellicle ; large and hard and covered with glairy mucus ; dark-colored.

Before stool : ineffectual urging with or without tenesmus ; complete atony of rectum ; severe colic-like pains with constriction or spasm of anus.

During stool : great effort ; violent colic pains.

After stool : colic and at times diarrheic discharges.

Attacks of constipation ; enemas of little or no service ; stool attended with terrible agony, as bad almost as labor ; stools were in hard balls ; during worst pain felt a drawing from navel backward to spine.

For last three weeks stools which were always rather costive became more scanty and difficult, injections and purges brought away small lumps of healthy-looking feces ; abdomen began to swell and increased daily in size until it was as large as that of a woman seven months pregnant ; swelling greater on left side, and completely filled up space between spine and navel ; convolutions of bowels filled with hard feces could be distinctly seen and felt ; on right side it felt as if a bag not quite filled with fluid lay there ; swelling not very tender to pressure, but prevented her lying upon side ; at times very violent, spasmodically contractive, cutting pains with great restlessness, anxiety and cold sweat, whereupon lumps size of fist appeared on left side ; after eating, violent retching and vomiting sometimes of food sometimes of mucus ; loss of appetite ; tolerably clean tongue ; great thirst ; flow of urine slightly diminished ; skin somewhat shrivelled ; weak, pale, emaciated, hollow-eyed.

Gradual loss of strength ; constant sickness ; acid eructations ; vomiting of every article of food taken ; constant dull pain in hepatic region ; violent attacks of enteralgia ; constipation, bowels will not act without a purgative, motions hard and dark ; numbness of upper and lower extremities ; a sort of semi-paralytic condition of arms so that knife would frequently drop from hand ; expulsive power of bladder weakened, urine expelled with difficulty and in a dribbling manner ; urine high-colored and fetid ; sexual functions much weakened ; pulse weak and quick ; extremely weak and emaciated.

Constipation interrupted by an attack of diarrhœa every week or ten days ; latter always came on between midnight and morning with great urgency for stool and violent pains in abdomen, > by passage of copious liquid discharge ; several discharges would occur during morning, sometimes continuing through day, and then she would be costive again ; with diarrhœa, sensation as of something pulling at umbilicus with actual retraction of navel.

Obstinate habitual constipation : when the stools are dry and lumpy and the intestines half paralytic and half crampy ; in pregnant women and in persons of a paralytic diathesis, or when due to paralysis of intestines ; especially when there are present dryness of the excretions and a muscular atony ; often there is an absence of intestinal mucus and bile ; when Platina fails.

Alternation of constipation and diarrhœa.

Light-colored stools. θ Jaundice.

Impaction of feces.

Intolerable pain, from spasms of rectum, with every evacuation lasting an hour or two ; suffering described as that of horrible constriction and spasmodic contraction, very much increased if feculent matter is solid ; for last ten years has taken aperients ; if evacuation were not liquid his torture was extreme ; if he passed a day without an evacuation the suffering lasted several days.

Spasmodic condition of rectum and anus.

Anus violently constricted and drawn up ; contraction of sphincter.

Prolapsus ani with paralysis.

Fissures of anus.

URINARY ORGANS [21]

Must get up two or three times at night to urinate ; urine profuse, acid, albuminous, containing fine granular and hyaline casts of small diameter and no renal epithelium ; much oppression for breath, making locomotion almost impossible ; when walking is seized with severe cramplike pain in region of umbilicus, > standing still ; perspires all over as soon as he gets into bed, perspiration comes and goes all through night ; cough on first waking, as he gets out of bed continues till after breakfast ; is caused by a sensation as if a "wheat-hull" were in throat just behind manubrium sterni ; lying on back or right side brings on cough ; when lying on back feels as if fluid rolled from one side of chest to other (subjective) ; in morning mouth and lips dry and lips swollen ; tongue dry ; lips crack open when coughing ; drinks at night on account of dry mouth ; marked weakness ; pasty, yellow look ; lungs are hepatized and heart diseased. θ Cirrhotic kidney.

General indisposition, loss of appetite, frontal headache, made < by mental application ; difficulty of breathing at all tires, but especially noticed when lying down at night, causing discomfort and loss of sleep ; both ankles highly œdematous ; skin dry, does not perspire, even when taking active exercise on a hot day ; a slight, dark cloud in urine, settles on standing ; urine acid, specific gravity 1016 ; albumen, 1/11 ; finely granular casts and some blood corpuscles.

Urine decreased in quantity, red, albuminous, containing blood corpuscles and epithelial cells, crystals of oxalate of lime and hyaline casts ; headache in occiput extending to forehead ; heavy, œdematous eyelids ; sunken eyes, staring look ; pains in limbs ; emaciation ; small, slow pulse ; hoarse voice ; catarrh of air passages with discharge of tough mucus ; dry, short cough ; cough with expectoration of blood ; constriction and oppression of chest ; coated tongue ; complete loss of appetite ; vomiting ; nausea for food ; belching ; vomiting of mucus ; constipation ; retention of urine ; cramps of bladder ; painful urination ; urine fiery-red, bloody, albuminous ; restless sleep ; obstinate sleeplessness ; great despondency and indifference. θ Desquamative nephritis.

Granular degeneration or cirrhosis of kidneys ; little dropsy or albuminuria, but a marked tendency to uremic convulsions.

Morbus Brightii : colicky pains ; retracted abdomen ; cutaneous anesthesia ; albuminuria ; rapid emaciation and excessive debility.

Morbus Brightii, contracted kidney.

Diabetes : lowness of spirits, anguish and melancholy ; diminution of sight ; dryness of mouth ; dry, cracked tongue ; suppuration of lungs ; hectic fever ; impotence ; dryness and brittleness of skin ; emaciation ; gangrene.

Urine dark-colored, brownish-red, turbid, with flocculent sediment, sp. gr. 1017, acid, albuminous ; sediment consisting of a number of red blood corpuscles and a large number of short, rather thick turbid cylinders studded with red blood corpuscles.

Albumen gradually diminished in quantity as less lead was found in urine ; later, albumen rapidly increased, and there was not an atom of urea in urine, sp. gr. being 1002.

Amaurosis and cerebral symptoms appeared and ceased coincidentally with the appearance and cessation of albuminuria.

Hæmaturia.

Complete suppression of urine.

Frequent vesical tenesmus : ineffectual urging to urinate ; sometimes after much effort, which increases the pains, urine passes in drops.

Urine : scanty, high-colored ; passed in drops ; strangury ; will not pass as from atony of bladder ; dribbles, is high-colored and fetid ; albuminous.

Complete paralysis of urinary organs from spinal degeneration.

Much trouble with urine in not being able to pass it, apparently from want of sensation to do so ; the will to do so cannot affect it, as if from paralysis.

Chronic paralysis of sphincter vesical.

Necrotic inflammation of bladder, caused by a decomposition of urea and formation of carbonate of ammonia, brought' on by catheterization and introduction of bacteride germs.

Urging to urinate every ten minutes ; urine discharged in drops, with extreme pain ; burning during and after urination ; sensation of constriction behind glans penis after urination ; urine at times containing blood ; < from motion ; > from absolute rest ; uses salt to excess. θ Strangury.

MALE SEXUAL ORGANS [22]

Increased sexual desire and violent erections.

Slight provocations produce erections and emissions.

Loss of sexual desire ; impotence ; chronic degeneration of cord.

Emissions, with relaxed organs, after wine.

Prolonged, painful, spasmodic stricture.

Testicles : drawn up ; feel constricted ; swollen, inflamed and painful.

Genitals swollen and inflamed.

Prostatorrhœa.

Chronic gonorrhœa.

FEMALE SEXUAL ORGANS [23]

Nymphomania.

Wants to stretch limbs during ovarian pains ; ovarian dropsy.

Cessation of menses on invasion of colic ; may reappear after paroxysm, or not again until next period.

Spasmodic dysmenorrhœa.

Menorrhagia, with a sensation of a string pulling from abdomen to back ; during climacteric period dark clots, alternating with fluid blood or bloody serum, with a sensation of fulness in pelvis and bearing-down pains in small of back ; skin dry, pale, yellowish ; "liver spots" here and there ; short of breath on going up stairs ; debility ; depressed spirits.

Vaginismus.

Strangulation of prolapsed portion of vagina ; intense pain.

Leucorrhœa, with inclination to miscarriage.

Mucous discharge from vagina.

PREGNANCY. PARTURITION. LACTATION [24]

Feeling as if there were not room enough in abdomen, at night in bed ; must stretch violently.

Pain drawing from abdomen to backbone, as if abdomen were drawn upward by a string ; depression of spirits ; constipation. θ Abortion.

She feels a lack of room for fetus in uterus ; inability of uterus to expand ; threatening abortion.

Abortion from lead poisoning ; or, if born, the child lives but a year or two.

Can scarcely pass urine ; apparently from want of sensation to do so ; the will to do so cannot effect it, as if from paralysis.

Puerperal eclampsia, especially with history of epilepsy ; albuminuria.

Milk scanty and watery, with great emaciation.

Pulling, tearing, contractive pains in mamma, uterus, and vagina, with or without colic ; the breasts become momentarily harder, or with the colic they seem smaller.

Induration and inflammation of mamma.

VOICE AND LARYNX. TRACHEA AND BRONCHIA [25]

Aphonia from paralysis of vocal cords.

Voice diminished both in power and vibration ; during paroxysms rough and stuttering speech or voice entirely gone ; pants in talking as if out of breath.

Spasmodic closure of rima glottidis ; mucus rattling in throat, with sudden difficulty of breathing and asphyxia.

Laryngismus stridulus.

Constriction of larynx.

Bronchitis, with copious muco-serous or purulent expectoration ; periodical asthmatic paroxysms.

RESPIRATION [26]

Respiration anxious and sighing with lamentations and moaning.

Want of breath ; oppression from motion ; short breath on going up stairs.

Heavy difficult breathing.

Spasmodic dyspnœa ; sudden paroxysms force him up at night to the open window, with paralytic symptoms of laryngeal muscles.

COUGH [27]

Cough : short, dry, nervous, fatiguing ; dry, spasmodic ; < during inspiration ; with purulent expectoration ; frequent, with bloody expectoration ; after hemorrhage from lungs, < lying on back and after getting out of bed in morning ; dry, hacking, with tuberculous diathesis ; in chlorosis.

Expectoration : copious, muco-purulent or purulent ; tasting sweetish ; bloody.

INNER CHEST AND LUNGS [28]

Pressure upon chest, with difficulty in breathing and short, dry, nervous cough.

Stitches in chest and sides.

Great emaciation : fever with evening exacerbation ; night sweats ; diarrhœa ; good appetite ; hectic flush ; constant cough, day and night, with profuse greenish, purulent, lumpy, blood-streaked expectoration ; dulness on percussion in apex of right lung, with rales. θ Phthisis.

Hæmoptysis : phthisical disposition, when bloody or purulent sputa alternate.

Hæmoptysis, with pus and blood and stitch pains in chest.

Phthisis ; suppuration of lungs ; large vomica in lungs ; chronic cough, with bloody expectoration ; palpitation.

Suppuration of lungs.

Circumscribed pulmonary mortification ; also cheesy pneumonia.

HEART, PULSE AND CIRCULATION [29]

Palpitation : violent ; spasmodic, with anxiety about heart.

Beats of heart very tumultuous, rapid and resonant.

Stitch in region of heart during an inspiration, with anxiety, heat and redness of face ; rushing of blood in region of heart, during a rapid walk ; anguish about heart, cold sweat ; violent palpitation and a sort of angina pectoris.

Hypertrophy and dilatation of heart.

Change in muscular structure of heart without coincident disease of valves and with or without atheromatous degeneration of vessels ; usually hypertrophy and dilatation of left ventricle ; ten cases out of twenty-five were associated with parenchymatous nephritis in stage of atrophy.

Bruit de souffle at base of heart ; cat's fremitus at apex.

Pulse : rapid ; weak and slow, about 40 ; variable, generally small and slow, contracted ; at times hard and slow ; at others small and accelerated ; dicrotic or undulating.

OUTER CHEST [30]

Chronic myalgia.

NECK AND BACK [31]

Tension in neck extending to ears when moving head.

Pains in back sometimes > by bending forward, at others when bending backward.

Stitches in back and small of back and between shoulder blades.

Pain in back, with sensitiveness of affected spot, by leaning on it ; in afternoon > after rubbing.

Chronic spinal meningitis, with sudden loss of flesh ; painful contraction of limbs ; colic with retracted abdomen.

Wasting palsy : local paralysis, chiefly of forearm, with atrophy of muscles and absence of anesthesia.

Multiple sclerosis : tremor of right arm during voluntary motion ; arms are "shaky" when he attempts to use them ; tremor of arms preceded by weakness and numbness ; tongue trembles when being protruded or when he tries to articulate ; speech dragging and slow ; diplopia ; dimness of sight ; neuritis of optic nerve.

Paralysis : anesthesia and hyper-anesthesia in spinal diseases.

UPPER LIMBS [32]

Convulsive motion of arms and hands, with pains in joints.

Debility of arms, with atrophy, loss of sensation and trembling.

Weakness and painful lameness of arms.

Numbness and want of power in extensor muscles of right forearm, those of thumb and index finger being almost paralyzed ; attack commenced eighteen months ago and was attributed to continuous knitting.

Very numerous dilatations of cutaneous veins of forearm, and under surface of lower third of upper arm.

Very numerous moniliform dilatations of veins on forearm, upper arm and back of hand, chiefly corresponding to the points of union of veins.

Wrist-drop.

Right hand, wrist and forearm mostly affected by paralysis (parts chiefly exposed to contact with paint).

Trembling of hands.

Knife drops from his hands. θ Constipation.

Paralysis of extensor muscles of fingers of right hand ; severe pains in abdomen ; constipation ; extraordinary tendency to sweat. θ Lead poisoning.

Wens on hands.

Paronychia ; onychia maligna and ingrowing toe nails.

Swollen red spots on fingers.

LOWER LIMBS [33]

Lacerating pain without redness or swelling in forepart of thighs and knees ; < at intervals ; decidedly < by movement and scarcely alleviated by pressure.

Violent pains in lower extremities, chiefly in anterior portion of thighs and calves.

Most violent pains, extending from hips to knees, as if pierced with needles.

Feeling of numbness outside of right leg, from hip to knees, always coming on at night and continuing for an uncertain time, also felt in morning ; of late it had increased to actual insensibility, so that he could run a pin into skin without pain ; skin and parts below felt hard ; frequently came on after walking about room in morning.

Paralytic sensation in hip, knee and foot joints, especially the latter two, the feet are pressed to the floor with difficulty, as if they were made of wood.

Drawing pressing pain n posterior part of thigh along course of sciatic nerve, extending to knee ; gait limping, difficult ; very tired after walking ; after Sulph., pains became periodic, appearing with great severity every other evening and lasting several hours, followed by great weakness of thigh ; headache.

Sciatica : drawing pressive pain in course of nerve from posterior part of thigh of knee, especially when the painful space is wider than the nerve track ; walking is difficult and exhausting ; colic.

Sciatica, when there is marked consecutive muscular atrophy ; or earlier, then walking causes great exhaustion.

Painfulness of loins, nates, posterior portion of thigh, knee, sole of foot and toes ; pain is equally severe on both sides and is felt somewhat on inner surface of lower limb ; usually consisting of prickings or lancinations, with occasional attacks of cramps.

From time to time very sharp neuralgic pains, always seated in lower limbs, though not limited to the joints or to any particular spot.

Extremely acute and paroxysmal pains, as well as cramps, in lower limbs.

Pains in lower limbs < in paroxysms.

Lightning-like pains in lower limbs.

Lame feeling in legs.

Paralysis with atrophy of legs after parturition ; loss of motion and sensation ; coldness of affected parts ; impossible to stand ; involuntary stool and urination.

Pains in legs, especially at night.

Enlarged veins on calves, with numerous varicose dilatations.

Cramps in calves.

Swelling of feet.

Fetid foot sweat ; fetid sweat on soles ; sweat smelling like old cheese.

Intense pain in great toe at night, which nothing relieves.

Ingrowing toe nails.

LIMBS IN GENERAL [34]

Violent pains in extremities, beginning in fingers, extending through elbows and upper arms ; then beginning in feet and finally affecting whole body.

Pains in extremities, especially in evening and night.

Neuralgic pains in limbs.

Pains in limbs < in paroxysms, so severe that he cries out ; somewhat > by pressure ; < from motion.

Vague wandering pains in limbs.

Lancinating pains all along inner surface of upper and lower limbs ; sometimes cramps ; at times these neuralgic pains cause as great suffering as the colicky paroxysms.

The pains in limbs are < at night and are > by rubbing ; < from pressure but > from friction ; during pain desires to extend upper and lower extremities.

The left side twitches, tingles and then "goes to sleep."

Alternate jerks of flexors and extensors.

Jerking, trembling or numbness of limbs.

Not a loss of power, but uncertain, irregular motions of limbs during height of pains, ceasing when pains stop.

Paralysis of limbs.

Paralytic weakness of extremities, especially on right side ; hands and feet cold ; total want of sweat.

Paralysis of extensor muscles of fingers and toes, both sides, after injections of morphine for rheumatic pains.

Paralysis : of wrist or arms ; first cramp, then loss of sensation and sudden emaciation, with coldness of parts ; feet are shortened ; extensors most affected ; preceded by trembling colic, apoplexy or spasms ; the paralyzed parts may swell after the emaciation.

Paroxysms of paralysis.

REST. POSITION. MOTION [35]

Rest : constriction behind glans penis >.

Lying down : pressure in epigastrium > ; difficulty of breathing ; all symptoms better.

Lying on right ride : impossible, swelling in abdomen ; brings on cough.

Lying on left side : violent palpitation worse.

Lying on back : brings on cough ; feels as if fluid rolled from one side of chest to the other ; cough worse.

Stooping : vertigo.

Bending forward : pressure in stomach ; pains in back better.

Bending backward : pressure in stomach > ; pain in epigastrium > ; pains in back better.

Bending double : > colic.

Leaning on back : sensitiveness.

Inclination to take strange attitudes and positions in bed.

Wants to stretch limbs : during ovarian pains.

Rising in morning : terrible pains in stomach.

Motion : pain in epigastrium < ; pain in abdomen < ; cecum and ascending colon < ; constriction behind glans penis < ; of head, tension in neck and ears ; pain in thighs >.

Walking about room : numbness of leg ; very tired.

Going up stairs : shortness of breath.

Rapid walk : rushing of blood in region of heart.

Active exercise : does not perspire ; coldness.

NERVES [36]

Anesthesia or excessive hyperesthesia.

Diminished sensibility on whole right side of body.

Lassitude ; faintness ; faints on going into a room full of company.

General debility ; great prostration.

Restlessness and uneasiness.

Spasms : colic ; tonic ; convulsive movements of limbs ; from cerebral sclerosis or tumor ; epileptic ; epileptiform.

Immobility of affected part.

Epileptic fits, at first seldom and irregular, but soon regularly and coincident with menses ; attacks very severe, lasting for hours, followed by great drowsiness and lassitude, compelling her to pass following day in bed ; menstruation exceedingly painful, so that its approach fills her with great fear ; severe frontal cephalalgia ; constant sleepiness ; for several years severe colic and obstinate constipation ; face dirty pale ; very poor memory ; low-spirited, frequently sits in abject despair ; strabismus, jerking with head, dragging speech, with slight frothing at mouth while talking.

Epilepsy, chronic form ; before spell vertigo ; legs heavy and numb, tongue swollen ; afterwards long-lasting stupid feeling in head and prolonged snoring sleep ; no aura, but sighing may precede the attack.

Epilepsy ; after fit consciousness returns slowly and symptoms of paralysis remain ; chronic cases, with earthy color of face, stupor and debility after fit ; periodicity.

Epilepsy, proceeding from splanchnic system ; swelling of tongue, which hangs from mouth and gets bitten.

Chorea of three years' standing ; left arm partially paralyzed.

Globus hystericus ; hysterical paralysis.

Hemi-and paraplegic anesthesia ; hemiplegia which is often accompanied by hyperesthesia of opposite side ; hysteria.

Arthralgic and neuralgic pains in trunk and limbs.

Tremor ; tremor followed by paralysis.

Paralysis : preceded by mental derangement, trembling, spasms or by shooting, darting, intense, tearing pains in tracks of larger nerves ; the parts emaciate ; wrist-drop, caused by apoplexy, sclerosis of brain or muscular atrophy, alternating with colic ; after apoplexy rapid emaciation, atrophy and loss of sensation of affected part ; of arms, with pain, dryness, deathly paleness and coldness of hands.

Paralyzed parts soon fall away in flesh and the limbs are painfully contracted : complete palsy, with excessive waste of tissue ; lowness of spirits and indifference ; loss of memory ; sleeplessness, or sleep disturbed with dreams or hallucinations ; ringing in ears ; weakness of sight ; diplopia ; vertigo ; sunken features ; weakness of sexual powers ; oppression of chest ; incomplete, difficult, noisy, moaning respiration ; constriction in precordial region ; paralysis of upper and lower limbs ; pulse small, soft, easily compressible ; deep-seated anesthesia of limbs and trunk.

Progressive locomotor ataxia.

SLEEP [37]

Drowsiness ; somnolency.

Great disposition to yawn and stretch, with restlessness.

Great sleepiness during day ; sleepless at night ; sleepless from colic.

Inclination to take strangest attitudes and positions in bed.

All symptoms < at night and by lying in bed.

TIME [38]

Morning : several discharges ; mouth and lips dry and lips swollen ; cough < getting out of bed ; after walking about room numbness of leg.

Day : sopor ; great sleepiness.

Afternoon : pain in back.

Evening : weak and exhausted ; vomiting ; exacerbation ; pains in extremities < ; chill increases ; internal chill and external heat ; heat.

Night : delirium furious ; sleeplessness ; neuralgic pains in and around eye < ; vomiting especially early morning ; weak and exhausted ; sensation in abdomen causing her to stretch ; pain in abdomen < ; must get up several times to urinate ; drinks on account of dry mouth ; difficulty of breathing when lying down, must stretch violently ; sweats ; numbness of leg ; intense pain in great toe ; pain in extremities < ; sleepless ; all symptoms < ; heat ; violent pains in bones.

TEMPERATURE AND WEATHER [39]

Effects most marked in rough and foggy weather.

Open air : vertigo > ; coldness ; sensitive.

Damp weather : salivation profuse.

Cold water : violent thirst.

FEVER [40]

Coldness : in open air and when exercising ; of hands and feet.

Chill predominates, increasing towards evening, with violent thirst and redness of face.

Internal chill and external heat, in evening.

Chilliness in all the limbs.

Heat : with thirst, anxiety, redness of face and sleepiness, in evening and at night, with yellowness of buccal cavity.

Sweat : anxious, cold, clammy, as soon as he gets into bed ; cold, viscid, with anxiety.

Absolute want of sweat.

ATTACKS, PERIODICITY [41]

The ailments develop slowly and intermit for a time ; intermission every third day.

Periodical : pains in abdomen ; asthmatic paroxysms ; epilepsy.

Paroxysmal pains : in right side of abdomen ; in lower limbs.

Alternating : delirium with colic ; gloom and taciturnity and frantic delirium, colic and constipation ; diarrhœa and constipation ; dark clots and fluid blood during menses ; jerks of flexors and extensors ; paralysis and colic.

Every three minutes : spasms.

Every forenoon : pain above umbilicus.

Nightly : tearing pains in eyes.

Every other evening : pains in thigh.

Every second or third day : stool.

Every week or ten days : constipation interrupted by an attack of diarrhœa.

Every ten days : urging to urinate.

For three years : chorea.

LOCALITY AND DIRECTION [42]

Right : pain in temple ; dimness of vision ; paralytic weakness of side ; pain in side of abdomen ; side sensitive to pressure ; strangulated hernia ; as if a bag filled with fluid lay in abdomen ; tremor of arm ; numbness and want of power in extensor muscle of forearm ; wrist and forearm most affected by paralysis ; numbness in outside of leg ; paralytic weakness of extremities ; diminished sensibility of side of body.

Left : muscles of side paralyzed ; eye affected ; angina ; severe pain in leg ; sensitive swelling on side of umbilicus ; strangulated hernia ; lumps size of fist appear on side ; hypertrophy and dilatation of ventricle ; side twitches, tingles and then "goes to sleep ;" arm partially paralyzed.

From left to right : tonsillitis ; angina granulosa.

SENSATIONS [43]

As if something were working at top of head, with a sense of screwing from behind forward ; eyelids as if paralyzed ; as if a ball were rising from throat into brain ; cornea as if breathed upon ; eyes as if too large ; as of a plug in throat ; as if everything were weighted down, with general indisposition ; as if abdominal walls were pulled inward ; as if abdomen and back were too close together ; as if bowels were twisted ; as if abdomen were drawn to spine by a string ; intestines as if constricted ; as if drawing in from abdomen to back ; intestines as if distended with gas ; as if abscess were forming near umbilicus ; sphincter ani as if drawn in ; as if a bag not quite filled with fluid lay in bowels ; as if a wheat-hull were in throat ; as if fluid rolled from one side to other in abdomen ; as if there were not room enough for fetus in uterus ; as if thighs were pierced with needles ; as if feet were made of wood.

Pain : in upper part of neck and back of head ; in occiput ; in back ; at umbilicus radiating to lumbar region and extending to chest, to small of back, kidney, bladder and lower extremities ; in limbs ; in joints ; in lower limbs.

Extremely acute pains : in lower limbs.

Excessive pain : in abdomen.

Terrible pains : in epigastrium.

Intolerable pains : with every evacuation.

Intense pain : in vagina ; in great toe.

Excruciating, tearing pains : in all the bowels.

Excruciating colic.

Violent pains : in paralyzed parts ; in integuments of skull ; in umbilical region ; in abdomen ; in lower extremities ; from hips to knees ; in extremities.

Severe pain : in stomach ; in abdomen.

Severe shooting pains : through body.

Tearing pains : in eyes and forehead ; in ears ; in jaws ; in abdomen ; in mamma.

Lancinations : in lower limbs.

Lacerating pains : at umbilicus and epigastrium ; in forepart of thighs and knees.

Cutting, contractive pains : in bowels.

Cutting : in stomach and bowels.

Lightning-like pains : in lower limbs.

Darting pain : in region of liver.

Stitches in ears ; in chest and sides ; in region of heart ; in back and small of back and between shoulder-blades.

Pulling pain : in mamma.

Pulling, pressive pain : in head.

Drawing pain : from abdomen to back ; in posterior part of thigh ; in course of sciatic nerve.

Neuralgic pains : in and around eye ; in lower limbs ; in trunk.

Vague, wandering pains : in limbs.

Paroxysmal pains : in right side of abdomen.

Contractive pain : in mamma.

Bearing-down pains ; in small of back.

Cramping : of limbs ; of bladder ; in calves.

Sticking pain : in hepatic region.

Prickings : in lower limbs.

Stinging : in region of liver.

Burning : in œsophagus and stomach ; in tonsils ; in epigastrium ; in liver and spine ; in abdomen ; in anus ; in perineum and rectum ; in ulcers.

Heat : in liver and spine.

Dull pain : in hepatic region.

Pressure : about stomach ; upon chest.

Constriction : in throat ; of intestines ; of navel ; of anus ; of chest ; behind glans penis ; of testicles ; of larynx.

Painful lameness : of arms.

Painfulness : of loins, nates, posterior portion of thigh, knee, sole of foot and toes.

Tightness : about stomach.

Tension : in neck to ears.

Weight : in back part of head.

Heaviness : in head ; in stomach ; in occiput.

Fulness : in pelvis.

Oppression : of breath.

Hard, knotty feeling of the muscles in various places.

Weakness : of thigh.

Lame feeling : in legs.

Trembling : of tongue ; of hands.

Numbness ; of upper and lower extremities ; of extensor muscles of right forearm.

Paralytic sensation : in hip, knee and foot joint.

Dryness : of hair ; of lips ; of mouth ; of hands ; of skin.

Chilliness : of all the limbs.

Coldness : of legs ; of hands and feet.

TISSUES [44]

Anemia.

Chlorosis : orthopnea ; obstinate constipation ; œdema of feet and anasarca ; unusual muscular debility ; scanty or suppressed catamenia.

The number of red blood corpuscles is very largely diminished, but their size becomes greatly increased, being relatively to the size of healthy blood corpuscles as nine to seven, true macrocythemia.

Blood under microscope shows an abnormal number of white globules.

Emaciation : extreme, with anemia and great weakness ; of paralyzed parts followed by swelling.

Great muscular weakness.

Constriction of muscular fibre, both voluntary and involuntary.

Muscular atrophy from sclerosis of cerebro-spinal system.

Arthralgia.

Wandering pains ; severe shooting pains through body.

Pains in joints as if being paralyzed.

Suddenly violent tearing, jerking, cracking in bones, occurring at night and depriving one of sleep.

Gout is more frequent in persons suffering from lead-poisoning.

Dropsical swellings ; anasarca.

Small wounds inflame and suppurate easily.

Stab wounds inflame, suppurate and heal rapidly.

Indurations after inflammation.

TOUCH. PASSIVE MOTION. INJURIES [45]

Touch : pain in abdomen < ; cecum and ascending colon sensitive ; ileo-cecal region painful ; sensitive especially on arms and eyelids.

Pressure : hepatic region sensitive ; > pain in abdomen ; whole right side sensitive ; spot around umbilicus sensitive ; pain in thighs scarcely alleviated ; pains in limbs <.

Hard pressure : pressure in stomach > ; colic >.

Rubbing : stinging in liver > ; colic > ; pain in back > ; pains in limbs >.

SKIN [46]

Sensitive to open air ; to touch, especially on arms and eyelids.

Skin : rough, dry ; scaly ; feels dry and cool ; yellow, or pale bluish ; pale clay-colored, dingy ; withered yellow ; surface pale.

Yellow skin ; jaundice.

Dark brown spots on skin ; "liver spots" in climacteric years.

Burning and smarting as from fire.

Erysipelas of nose.

Serous infiltration and puffy appearance of skin.

Serous infiltration of mamma.

Excoriations ; decubitus.

Burning in ulcers ; small wounds become easily inflamed and suppurate.

Gangrene.

Burns when there are yellow ichorous vesicles, burning, itching, threatening gangrene.

STAGE OF LIFE, CONSTITUTION [47]

Girl, æt. 10, suffering three years ; chorea.

Woman, æt. 25, single well built, suffering five days ; colic.

Man, æt. 26, suffering since childhood, mother similarly afflicted ; cardialgia.

Woman, æt. 26, poor, of delicate frame, after hard work and a fit of anger ; miserere.

Mrs. C., æt. 28, small frame, quick, nervous temperament, dark hair and eyes, had typhoid fever, since then suffering ; diarrhœa.

Man, æt. 30, strong, after catching cold five months ago ; affection of stomach.

Woman, æt. 30 ; intussusception.

Man, æt. 30, suffering since childhood ; offensive foot sweat.

Lady, single, about 30, middle height, thin and wiry, dark brown hair, parents are cousins, suffering thirteen years ; epilepsy.

Engineer, æt. 30, has had three similar attacks ; paralysis of extensors of fingers and toes.

Man, æt. 30, for fifteen years has followed the sea, handling much paint and painting ; lead paralysis.

Woman, æt. 32, married, weakly, slender, tuberculous, suffering with chronic cough ; sciatica.

Man, æt. 33, cheese-monger, suffering nine or ten weeks ; constipation.

Lady, æt. 36, subject to bilious attacks ; jaundice.

Lady, æt. 36, sanguine nervous temperament ; tumor cecum.

Woman, æt. 36, mother of four children ; phthisis.

Man, æt. 39, during youth addicted to masturbation, married at 23, but soon after was separated from wife, when he resumed the habit and continued it for seven or eight years ; suffering eight or ten years ; mental disorder.

Mrs. E., æt. 40, suffering one year ; cardialgia.

Man, æt. 40, brewer, corpulent, accustomed to drink considerable quantities of beer and wine, was seized with an attack of ague which was suppressed by quinine, after which he suffered from great prostration accompanied by gastric disturbance and icterus, on return of paroxysm of ague, a nephritis and right sided lobular pneumonia developed, latter yielding to Tart. stibiat. ; desquamative nephritis.

Lady, æt. 44, eighteen months ago confined to house, when she knit continuously, since then suffering ; weakness and paralysis of extensor muscles of fingers.

Man, æt. 46, florid complexion, stout, active habits, temperate in diet, suffering fifteen months ; nervous affection of leg.

Man, æt. 50 ; stricture of œsophagus.

Mrs. R., æt. 50 ; constipation.

Man, æt. 50, suffering ten years ; spasms of rectum.

Man, æt. 50, good habits, well nourished, has always enjoyed good health ; cirrhotic kidney.

Man, æt. 50, after severe abdominal affection, accompanied by constipation, was subject to profuse bleeding piles ; anemia.

Man, æt. 52, lawyer, good stature, robust frame, family history good, ailing three years, disease said to be fatty degeneration of heart, had severe double pneumonia, is prone to attacks of bronchitis ; cirrhotic kidney.

Man, æt. 53 ; constipation.

Mrs. ---, æt. 54, subject to severe attacks of hysteria, from puberty till cessation of menstruation nine years ago, after being excited by religious disputes and receiving a sudden shock from seeing a lady on her death-bed ; mental disturbance.

Mrs. Kuchler, æt. 58, laborer's wife, passed through climaxis without any particular ailments, tendency to constipation ; impaction of feces.

Widow, æt. 60 ; intussusception.

Man, æt. 60, teacher, uses salt to excess and drinks much beer, suffering three months ; strangury.

Girl, suffering several years ; gastralgia.

Man, baker ; enteralgia.

Mrs. R., suffering many years from large femoral hernia ; strangulated hernia.

Teamster ; paraplegia.

RELATIONS [48]

Antidoted by : Alumen, Arsen ., Alum ., Ant. crud., Bellad., Coccul., Hepar, Kreos., Nux vom., Opium , Petrol ., Platin ., Sulph. ac ., Zincum . Alcohol is a preventive.

Compatible : Arsen., Bellad., Lycop., Mercur., Phosphor., Pulsat., Silica. Sulphur .

Compare : Lycop., Phos. ac ., in mental conditions ; Pulsat . in venous circulation ; Alumina, Platin., Opium , in colic and enteralgia ; Bellad., Nux vom ., in strangulated hernia ; Natr. nitr., Podoph ., in retraction of navel ; Arsen . in skin symptoms, especially burns ; Thallium in sciatica.