Sanguinaria canadensis

Volume I — Special Symptomatology

{Blood-root.)

Botanical Description. — Sanguinaria is a spring plant, found in Canada, and all parts of the United States, excepting southward to Florida and westward to Mexico and Oregon. It generally grows in rich lands, covered with forests and shaded in summer, avoiding the sea coast and high mountains.

The root is perennial, horizontal, oblong, and, when green, nearly of the length of the finger, from one-fourth to one-half an inch in diameter, knotty, fleshy', with numerous radicles. Its praemorse or abrupt form is occasioned by its making off-sets from its sides, which off-sets separate as the root decays. Its color, externally, is reddish-brown ; but internally it is paler. It is succulent, and, when cut or broken, it emits, from numerous points on the tranverse surface, a bright orange, or rather dark vermillion colored juice, which has a bitterish, acrid, but peculiar taste, which remains long in the mouth, and leaves a persistent burning in the throat. The juice of the stem is between a red color and a yellow, as that from the stem of Chelidonium majus is pure yellow, and that from Papaver is white.

The chemical analysis shows it to contain an alkaloid called Sanguinarina. Dr. James Schiel, of St. Louis, claims to have determined the identity of Sanguinarina with Chelrythrin, obtained from Celandine. It also contains chelidonic acid.

Officinal Preparations. — Tincture of the root, with strong alcohol; dilutions; triturations of the dried root, and of the Sulphate and Nitrate of Sanguinarina.

Analogues. — Arsenicum, Asclepias tub, Ammonium caust, Arum, Asarum, Belladonna, Bromine, Bryonia, Galcarea carb., Causticum, Chelidonium, Drosera, Hepar sulph., Iris, Lachesis, Lycopodium, Mercurius, Phosphorus, Bumex, Senega, Spongia, Stannum, Sulphur, Tart. emet.

Mental Sphere. Mind confused, relieved by eructations, (p.) Anxiety followed by delirium. Delirium with hot skin. Stupor, heaviness, sleepiness.

Extreme moroseness, with nausea, cannot bear to hear a person

walk in the room. Hopefulness, sanguine of recovery from illness. («.)

Head.

• Vertigo with singing in the ears.

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• Vertigo with diminished vision before vomiting.

• Vertigo with nausea and headache, followed by spasmodic

vomiting.

• Vertigo on quickly turning the head, and looking upwards.

• Determination of the blood to the head, with whizzing in the

ears, and flashes of heat. Pressing drawing in the forehead, with heaviness of the head, better while walking.

• Headache as if the forehead would split, with chill, and with

burning in the stomach. Periodic stitches in the left temple and forehead, worse in evening.

• Painful soreness in small spots, especially on the temples. Headache with rheumatic pains and stiffness in the limbs and

neck.

• Pain in the head in rays, drawing upward from the neck.

• Beating headache with throbbing in the temporal arteries

and bitter vomiting.

A feeling as if the head is drawing forward.

Sensation of looseness in the scalp, on raising the eyes.

Headache with a nausea and chill, then flying heat from the head to the stomach.

° Migraine with bilious vomiting, pains begin in the morning, last till evening; eyes feel as if they would be pushed out, aggravated by motion.

c Headache relieved only by pressing on the back of his head.

0 Headache which occurs paroxysmally, once a week or longer, the pains begin in morning, increase all day, and last till evening; the head seems as if it must burst; the pain is digging, piercing, or throbbing, lancinating through the brain, on the forehead and top of head, worse on the right side, followed by chills, nausea, vomiting, and only relieved by sleep. (Hering.)

° Frightfully severe headache, the only relief obtained was from pressing the back of his head against the headboard of the bed. (Hering.)

° One of the most important indications for Sang, in headache

is, " Pain like a flash of lightning on the back of the head." (JVeidhard.)

° Myalgic headaches; 0 Rheumatic headaches; "Congestive headaches; c Headaches at the "change of life;" 0 Headache from suppressed menses; ° Dyspeptic headache; ° Migraines. (Bale.)

0 Sanguineous apoplexy, with vertigo, dimness of sight, vomiting, burning in the stomach, and distension of the temporal veins. (Hale.)

0 " North American sick headaches." (Hering.)

Face.

• Distension of the veins of the face and temples, with exces

sive redness; a feeling of stiffness.

• Stitches in the left side of face, with pains in the forehead. Severe burning, heat and redness of the face.

• Paleness of the face, with disposition to vomit. ° Red cheek, with burning of the ears.

° Redness of the cheeks, with cough.

° Cheeks and hands livid in typhoid pneumonia.

Nose.

• Fluid coryza, with frequent sneezing; worse in right nostril.

• Watery, acrid coryza, rendering the nose sore, with copious

watering of the right eye. (The coryza disappears when diarrhoea sets in.) ° Acute and chronic coryzas, with loss of smell. ° Influenza, with rawness in the throat, pain in the breast,

cough, and finally diarrhoea. 0 Nasal polypi^ or fungous growths in the nostrils (use the

tincture or powder topically). 0 Nasal catarrhs, chronic, with offensive discharges; (use 2 trit.

as a " snuff.") ° Ulcerative ozsena, with epistaxis. (Hale.)

Eyes.

Watering and burning of the right eye, which is painful on

being touched, then coryza. Feeling as if hairs were in the eyes, or as if smoke was in

them.

Glimmering before the eyes, diminished power of vision,

worse in the afternoon. Dilatation of the pupils with vertigo (from the seeds). 0 Catarrhal ophthalmia, granular lids. [Hale.) 0 Ophthalmia followed by ulceration of the cornea. [Hale.) ° Is useful as a collyria in chronic conjunctivitis (2 x aqueous

dil).

Ears.

Beating under the ears, at irregular intervals, only a couple of strokes.

• Burning of the ears, with redness of the cheeks.

• Earache, with headache, with singing in the ears and vertigo Humming in the ears, with determination of blood. Painful sensitiveness to sudden sounds.

° Acute internal otitis (also perhaps myringitis). ° Catarrhal affections of the inner ear. ( Woodyat.)

Mouth and Teeth. Stiffness of the jaws, and pain in the upper teeth.

• Toothache from picking the teeth.

° Grumbling toothache, with pain in same side of the head. Toothache worse from drinking cold water, better from warm

drinks (coffea the reverse). Looseness of the teeth and salivation. Shooting and thrilling pain in a carious tooth.

• Spongy, bleeding, and fungoid condition of the gums. Loss of taste and smell, with a burnt feeling on the tongue. Prickling sensation on the tongue and roof of the mouth. Feeling of dryness begins on the right side, spreading over

the whole tongue. Tongue sore, stitches on left side of the tongue. Sugar tastes bitter, followed by burning in the fauces. "White coated tongue, with slimy, fatty taste in mouth.

Throat.

Dryness, sensation of, not diminished by drinking. Heat in the throat alleviated by inspiration of cool air. Burning in the throat after eating sweet things. 0 Throat feels swollen as if to suffocation, with pain when swallowing, and aphonia.

Pain, with feeling of swelling most on the right side, most perceptible when swallowing.

° Ulcerated sore throat, following quinsy.

p Tonsillitis, chronic, recurring frequently; prevents the recurrence. {Hale.)

Stomach and Gastric Symptoms.

• Soreness and pressure in the epigastrium, worse after eating.

• Burning in the stomach, with headache.

• Great weakness of digestion, with loss of appetite.

• Strengthens the stomach, excites the appetite, and stimulates

digestion.

• Inflammation of the stomach, with burning, vomiting, headad le, etc.

° Acute gastritis; ° chronic gastritis; ° atonic gastritis. ° Ulceration of the stomach. 0 Nausea not diminished by vomiting. *Loss of appetite and great weakness of digestion. Extreme nausea, with profuse water-brash. ° Vomiting, with severe painful burning in the stomach, and intense thirst.

° Pyrosis; a rising of burning, corrosive fluid from the stom

ach, for twenty years. (Fairbanks.) Soon after eating, a feeling of emptiness in the stomach. Jerking in the stomach, as if from something alive.

• JVausea, intense, in paroxysms, worse when stooping, with

flow of saliva; followed by nettle-rash; with heartburn; spasmodic eructations of flatus of unpleasant odor; with* headache, chills, followed by vomiting, and sometimes diarrhoea.

• Vomiting / before vomiting, great anxiety ; pressure to

stool; very disagreeable nausea; during vomiting, headache, burning in the stomach, with craving to eat; with, prostration; after vomiting, relief of the headache.

• Vomiting of bitter water; of sour, acrid fluids, and ingesta- ° In almost every form of indigestion, for many years, it hasgiven me satisfactory results. {F. W. Hunt.) ° Especially useful in deficient gastric secretion, with loss of appetite, and periodic nausea.

from congested mucous membrane and fermentation of food. (Ib.)

Abdomen.

Severe and continued pain in the hypochondria, with vertigo and debility.

° Pain in left hypochondrium, worse on coughing, better by pressure and lying on the left side. (° Splenitis?)

Beating and cramps in the abdomen, moving from one place to another.

Sensation as if hot water poured itself from the breast into the abdomen, followed by diarrhoea.

Paroxysmal cutting and drawing pains in the abdomen.

Colic-like pains in the morning, followed by diarrhceic stool.

Twisting pain on the left side, above the groin; worse when sitting, standing, or bending toward the right side, increased by pressure, better when walking erect.

° Jaundice. 0 Hepatic torpor. ° Biliary concretions.

° Atony of the liver. (Allopathic and Eclectic.)

° Cough from affections of the liver. (Hale.)

Pain in the top of the right shoulder.

Stool.

• Pressure to stool, without evacuation, with the sensation of

a mass in lower part of rectum, and discharge of offensive flatus only.

• Diarrhceic stools, watery, with great flatulence, preceded by

cutting pain.

• Diarrhoea in the evening, with disturbance of the coryza and

catarrh, and pain in the chest. Food passes away undigested. ° Dysentery. 0 Haemorrhoids.

Urine.

• Frequent urination, also at night, which is copious and clear

as water.

0 Very copious urine at night, with pain in left hypochondrium; worse from coughing; better from pressure and lying on left side. (Bates.)

\

Generative Organs.

Women. — * Pain in the loins, extending through the hypogastric and uterine region, and down the thighs, followed by the appearance of the menses (in cases of suppression).

• Abdominal pains (at night) as if the menses would appear. Menses are much too early, too profuse, with a discharge of

black blood. Uterine hemorrhage, followed by amenorrhoea. ° Threatened abortion, characterized by nausea, pains in the

loins, extending through the hypogastric and iliac regions,

and down the thighs. ° Flushes of heat, at the change of life.

° Distension of the abdomen in the evening and flatulent discharges per vagina, from the os uteri, which was constantly open, and at the same time a pain passing in rays, passing from the nape of neck to the head.

0 Burning of the palms of the hands and soles of the feet, at the climacteric period, compelling her to throw the bed clothes off, in order to cool them.

0 Ulcerations of the os uteri; corrosive and foetid leucorrhoea.

0 Polypi of the uterus. ° Cancer of the uterus.

0 Dysmenorrhoea in feeble, torpid subjects, with tendency to congestion of lungs, liver or head.

° Amenorrhoea, with disease of the lungs.

Breasts: Stitches in both breasts; soreness to the touch, under the right nipple, and painful soreness of the nipples. Larynx and Bronchia.

• Tickling in the throat in the evening, with slight cough and

headache.

• Dry cough, awakening him from sleep, which did not cease

until he sat upright in bed, and flatus was discharged upwards and downwards.

• Tormenting cough, with expectoration and circumscribed

redness of the cheeks. (Bute.) "Continued severe cough, without expectoration; pain in

breast, and circumscribed redness of the cheeks. ° Feels stronger and freer in the breast, mornings, and in the

afternoon and evening the customary dyspnoea does not appear.

0 Whooping-cough. ° Hydrothorax. ° Asthma. ° Pneumonia. 0 Cough, with coryza, then diarrhoea, which cures both.

• Chronic dryness in the throat and sensation of swelling in

the larynx, and expectoration of thick mucus. 0 Chronic laryngitis, bronchitis and trachitis.

• Continued severe cough, without expectoration, pain in the

head, and circumscribed redness of cheeks.

• Croup; catarrhal, with spasmodic, crowing, painful cough,

and stridulous breathing. {Hale.) 0 Pseudo -membranous croup; many severe and dangerous cases. (JVichol, Helmut h.)

[The primary action of Sanguinaria is like that of Tartar emetic. A loose, rattling cough, followed secondarily by a dry, painful, spasmodic, croupy cough, with scanty, tenacious expectoration. (Hale.)]

Chest.

• Pain in the breast, with cough and expectoration.

• Pain in the breast, with dry, periodic cough.

• Burning and pressing in the breast, heat through the abdomen, with diarrhoea. Stitches from the lower part of left breast to the shoulder.

• Slowly shooting pain in right chest, about the seventh rib;

and acute stitches in right breast.

Shooting pain under the sternum, and the region of the heart.

0 Pneumonia, with extreme dyspnoea, short, accelerated, constrained breathing, difficulty of speech, sputa becomes tenacious, rust-colored, and expectorated with much diffi culty.

0 Haemoptysis, during phthisis pulmonalis.

• Continued pressure and heaviness of the whole upper part of

the chest, with difficulty of breathing. ° Typhoid pneumonia, with very difficult respiration; cheeks and hands livid; pulse feels soft, vibrating, and easily compressed.

9 Pneumonia in second and third stages; with dullness on percussion; bronchial respiration, with red or grav hepatization ; and infiltration of the parenchyma. (Hale.)

""Syphilitic pulmonary inflammation." {Wolff, with the 200th.)

° Chronic pneumonia, where it rivals Sulphur or Phosphorus ° Hydrothorax. Asthma. ° Pleurisy. ° Intercostal myalgia

[Sanguinaria, in affections of the lungs, occupies a place mid-way between Phosphorus and Tartar emetic; it has many symptoms common to both, and some possessed by neither. It closely resembles Sulphur and Lycopodium, and in chronic diseases rivals them in its curative powers. Hale.)]

Heart.

Painful stitches in the region of the heart. Pressing pain in the region of the heart.

Palpitation of the heart (before the vomiting), with great weakness.

Irregularity of the hearts action, and of the pulse, with coldness, insensibility, etc.

Back.

Pain, stiffness, and soreness of the nape of the neck, left side, on being touched.

• Pain in the sacrum, from lifting. (Bute.)

Pain in the sacrum, alleviated by bending forward. Rheumatic pains in the neck, shoulders and arms. 0 Lumbago, from lifting; or myalgia of the great muscles of the back.

Upper Extremities.

Sudden rheumatic pains in the shoulder joints.

• Rheumatic pain in the right arm and shoulder; worse at night,

in bed ; (sometimes in the forenoon ;) cannot raise the arm. (Bute.)

• Pain in the right shoulder, and in the upper part of the

right arm, more at night, on turning in bed. (Jeanes.) Pain in the left shoulder, in the evening. Rheumatic pains in the arms and hands.

Severe pain in the hand, with aching in the arm, when lying quiet and warm in bed.

• Burning of the palms, redness of the hands, and severe burning lividity of the hands, in pneumonia. Stiffness of the finger-joints, also cutting and stitching pains.

Pain as if from a boil at the root of the nails on all the fingers.

0 Ulceration of the roots of all the nails on both hands. {Bute.)

Lower Extremities. Rheumatic-like pains in the left hip.

Pain as from a bruise in the left hip joint, whilst walking, but

worse on rising from a seat. Rheumatic pain in inside of right thigh, alternating with pain

in the chest.

• Burning in the soles of the feet; worse at night. Stiffness and tightness in the knees and under the knees.

• Acute swelling of the joints of the extremities.

0 Acute, inflammatory, and arthritic rheumatism. On touching the painful part, the pain vanishes, and appears elsewhere.

• Paralysis of the right side.

0 Pains in those places where the bones are least covered with flesh.

Fever.

Chill with headache, nausea and shivering in the back in the evening in bed.

Shaking pain, with chill under the shoulder-blade on motion. Heat flying from head to stomach.

Burning heat, rapidly alternating with chill and shivering. Gradual increase in the force, and frequency of the pulse. Slow pulse, with extreme nausea.

° Coldness of the feet in the afternoons, with painful and sore tongue; stiffness of the knee, and finger joints {Bute.) ° Hectic fever, with cough, circumscribed redness of the cheeks. 0 Fevers from pulmonary, hepatic or gastric inflammation.

Sleep.

Sleeplessness at night, waking with fright as if he would fall. Dreams of a frightful and disagreeable character. Dreams of sailing on the sea.

Skin.

Heat and dryness.

Itching and a nettle-rash before the nausea.

c Fungous growths. 0 Scaly eruptions; carbuncles.

charge.

Generalities.

A quickly diffused, and transient, but at the same time a very peculiar thrill, often extended to the minutest extremity. General torpor and languor; dilatation of the pupils. •

Volume II — Special Therapeutics

semble those of Digitalis. It is remarkable, however, that it seldom influences the pulse, either in frequency or tension, until it has been used for five or six days ; and in a majority of cases the effect is not seen for eight or ten days. — Tully.

Zollikoffer says it is “sudorific, emetic, and purgative.” Smith, Thatcher, and Allen compare it to Digitalis. Tully says it unites the properties of Scilla, Ammonia, Senega, Digitalis, and Guaiacum without their violent operations. Rafinesque says it is “acrid, narcotic, emetic, deobstruent, sudorific, expectorant, vermifuge, escharotic, stimulant, and tonic.”

The diseases in which Sanguinaria has been hitherto thought most useful are those of the throat, chest, stomach, and liver. It has been most frequently employed in incipient phthisis, bronchitis, catarrh , influenza, pneumonia, asthma, croup, diphtheria, cynanche maligna or putrid sore throat, in which it produces the best effects when applied locally. It has also been useful in scarlatina, pertussis, dyspnoea, dyspepsia, hydrothorax, and jaundice. In the latter disease it was approved by Colden, and it formed the basis of Raws on’s specific for that disease.

Dr. McBride, of South Carolina, says that he used it with great advantage for u torpor of the liver, attended with colic and yellowness of the skin,” a disease very prevalent in that climate.

Dr. Ives, of New Haven, also used it for diseases of the liver, and in the first stage of croup. Western practitioners have carried it much farther. Some “ specifics ” are composed of it. It has also been successfully used in dysentery, amenorrhoea, inflammatory rheumatism, and rheumatic gout.

Blood-root is an acrid emetic, with narcotic and stimulant properties. It is also expectorant, sudorific, alterative, emmenagogue, tonic, antiseptic, detergent, and escharotic, according to the mode in which it is employed. It is a very active agent, and is capable of exercising a powerful influence on the system. When given in small doses it stimulates the digestive organs, accelerates the circulation ; in large doses it occasions nausea and consequent depression of the pulse ; in a full dose it produces active vomiting ; in overdoses it causes violent emesis, a burning sensation in the stomach, tormenting thirst, faintness, vertigo, dimness of vision, alarming prostration, and even death. — King.

Sanguinaria is emetic, expectorant, diaphoretic, acronarcotic, sedative, alterative, and, in small doses, tonic and stimulant. In full doses it induces nausea and vomiting, with a sensation of warmth in the stomach, acceleration of pulse, and slight headache. It acts on the fauces, producing an acrid impression, and in some cases it proves cathartic. The leaves and seeds possess similar properties.

The seeds, however, are said to exert a marked influence upon the brain and nervous system, occasioning torpor, languor, disordered vision, and dilated pupils ; in large doses the emesis is violent, there is a burning sensation in the stomach, faintness, vertigo, dimness of vision, and alarming prostration. — King.

Effects of Sanguinaria. — The late Professor R. P. Thomas, of Philadelphia, experimented with this substance, and obtained the following results :

In doses of from one-twelfth to one-eighth of a grain it acted merely as an expectorant, without disturbing the stomach.

In doses of one-sixth to one-fourth of a grain, every two hours, it produced nausea and sometimes caused vomiting.

In doses of one-half grain in solution, every ten minutes, it almost uniformly caused vomiting after the second or third dose.

In doses of one-eighth to one-sixth of a grain, every three hours, continued for two days or more, it generally reduced the pulse from five to fifteen beats per minute.

It is thus seen that the general pathogenetic effects of the chief alkaloid contained in the root were essentially, perhaps, the same as those long known to belong to the entire substance ; but our professional as well as our positive knowledge is almost entirely derived from experiments with the powdered root, the tincture, or other preparations from it. Like most of our best remedies it is, indeed, a very multifarious combination.

The toxical and pathogenetic effects of Sanguinaria indicate that it has a profound effect upon the nerves of sensation and motion, but the exact nature of thi5 action has not been sufficiently investigated. Among the symptoms we find “a quickly diffused and transient, but at the same time a very peculiar nervous thrill, which is often extended to the minutest extremity.” In large doses it causes “ torpor, languor, and dilatation of the pupils.”

There are a few drugs, like Pulsatilla, which seem to affect the mucous tissues of the whole system ; others, like Squills, have a specific affinity for the pulmonary mucous membrane; Sanguinaria is an analogue of the latter to a certain degree, although it more nearly approaches the action of Tartar emetic. It was known as an expectorant long before the allopathic profession brought it

into use, and now both that and the eclectic school value it highly for that purpose. Blood-root does not seem to notably increase the secretions from the intestinal mucous tissues.

It is said to be useful in pleuritis and synovitis.

Sanguinaria seems to cause pains of a rheumatic ov my algic character. It is difficult to decide which of the two affections were cured by this medicine in the reported curative symptoms. I am inclined to the opinion, however, that Sanguinaria, although it may cure some neuralgias, will not, like Colchicum and Cimicifuga, act specifically in rheumatic affections.

Sanguinaria has not been used in fevers generally, but it has been administered successfully in hectic fever. In the pathogenesis of no other medicine, except, perhaps, Phosphorus and Lycopodium, do we find the hectic paroxysm as perfectly delineated; generally, the hectic is associated with cough and other symptoms of lung affections, but there are exceptions.

Dr. Bute cured: (1.) In a lady, coldness of the feet in the afternoons, at the same time the tongue was painful and sore upon being touched, like a boil, and there was stiffness of the knee and finger-joints.

(2.) Burning of the palms of the hands and soles of the feet, compelling him to throw the bedclothes off the feet for the purpose of cooling them. These paroxysms generally come on in the p.m. or evening.

(3.) Paroxysm of fever in p.m., with circumscribed redness of the cheeks ; cough and expectoration:

Dr. Morrow relied on Sanguinaria as a remedy for haemorrhages in general, because of “ its power of quieting excessive or depressing the natural circulation.” He advises it particularly in haemoptysis ; it has also been used in menorrhagia, epistaxis, etc.

We can sometimes comprehend the sphere of action of a drug by comparing the ensemble of its symptoms with that of other drugs ; a careful analysis of the symptoms and toxical effects of Sanguinaria show its marked resemblance to three of our most important medicines, namely, Arsenicum, Phosphorus, and Tartar emetic; more remotely it resembles Belladonna, Lachnanthes, Veratrum viride, and Iris versicolor. Lycopodium, Sulphur, Kali

carbonicum and Rumex crispus have some symptoms in common with Sanguinaria.

The blood-root has been used successfully for scaly eruptions, old indolent ulcers, ill-conditioned ulcers with callous borders and ichorous discharge ; the powdered root is escharotic, and when applied to fungous growths causes their rapid disappearance. I consider it the best application we have for this purpose; it has also cured warts and polypi , when given internally and applied topically. Dr. Sholl uses it externally and internally for carbuncle with alleged success.

Dr. Bute found blood-root curative in headaches with “ distension of the temporal veins, which were painfully sensitive to the touch,” also with “ feeling of soreness on small spots of the head, especially in the temples.” Other physicians have cured cephalalgias with “ pains in the head, in rays drawing upward from the neck.” Dr. Hering considers it homoeopathic to the so-called North American sick headache. He has cured, with the high dilutions, the following symptoms :

Severe pains in the head, with nausea and vomiting, frequently with bilious vomiting, in attacks, with hebdomadal or longer intervals from very different inducements, commonly beginning in the morning, increasing in violence during the day, only diminished by lying quiet, and, when possible, by sleep.

Dr. Hering also gives the following indications for Sanguinaria:

It is the best remedy in most cases of migraine or sick headache. Still, it must prove most useful when the attacks occur paroxysmally, viz., every week, or at longer intervals ; or when the pains begin in the morning, increase during the day, and last till evening ; when the head seems to feel that it must burst, or as if the eyes would be pressed out, or when the pains are digging, attended with sudden piercing, throbbing lancinations through the brain, involving the forehead and top of the head in particular, and being most severe on right side, followed by chills, nausea, vomiting of food or bile, forcing the patient to lie down and preserve the greatest quiet, as every motion aggravates the sufferings, which are only relieved by sleep.

Case I. — A man was attacked with frightfully severe headache ; the only relief he could obtain was from pressing the back of his head against the headboard of the bed. An infusion of Sanguinaria root removed the headache permanently. — Hering.

Case II. — A lady suffered with frequent and severe attacks of headache, with such sensitiveness during the paroxysm that no one dared to walk across the room. Sanguinaria 6th was given, but the first dose produced such an aggravation that the patient became almost beside herself; after the second dose she fell into a pleasant sleep, from which she awoke refreshed. Dr. Helfrig always gave Aconite and Belladonna during the paroxysm of sick headache, and used Sanguinaria 30th during the interval, unless some other remedy was more indicated. — Hering.

Many of the symptoms of Sanguinaria are similar to those pains which Inman describes as belonging to myalgia headaches, particularly the superficial sensitiveness and drawing pains. Congestions of the head are controlled by this medicine, when the temporal veins are distended. It is probable that it is also homoeopathic to some of the varieties of apoplexy. Its known curative influence over haemorrhage from congestion would suggest its use in sanguineous apoplexy. The symptoms would seem to imply that venous congestions (if the term may be allowed) are most under the control of Sanguinaria.

Dr. C. Neidhard says :

One of the most important indications for the employment of Sanguinaria canadensis is this symptom : Pain like a flash of lightning on the back of the head.

Dr. E. W. Beebe reports the following remarkable cases of “sick headache” cured with this medicine:

Mrs. P., aged fifty-five, blue eyes, dark-brown hair, of nervo-sanguine temperament, full habit, and somewhat corpulent. The history of the case is as follows : Has been subject for a period of fifteen years to attacks of “ sick headache,” which commence in the morning on waking, and increase during the day, and are only relieved by sleep at night; the pain is confined chiefly to the temples and vertex, and so violent as to cause the patient to cry aloud. Nausea generally commences in the morning, followed by vomiting, first of the contents of the stomach, and afterwards of a substance that seems to be pure bile, with occasionally a considerable quantity of an acid mucus, with great distress in the stomach, of a burning character ; with great weakness or “ goneness,” as the patient described it, not amounting to a real pain, but which was even worse to bear than the headache ; not the least quantity of food or drink could be taken without its being immediately vomited. The attacks came on irregularly, sometimes once in a week or ten days, then again perhaps not for three or four weeks. The health of the patient is good otherwise, with the exception of slight constipation at times. She has been treated by a number of physicians of the eclectic, homoeopathic, and old schools of medicine, and has, as she informs me, received no benefit. I diagnosed the case as one of dyspepsia, from the use of highly-seasoned and rich food. I found also that the patient was in the daily habit of using strong coffee, which I prohibited, regulating the diet, etc. I then prescribed Nux and Bryonia, night

and morning, expecting these medicines to relieve, but, to my great surprise, the patient did not improve under the remedies, and after continuing them until I became satisfied that I had not made a right selection, I changed them for others, such as Ars., Puls., Chin., etc., which, together with the others generally used in such cases, were continued for some four or five months, at the end of which time I had found I had not lessened the frequency of the attacks in the least, nor had been able to relieve, for the time being, the vomiting, though I had administered Ipecac., Tartar emetic, etc., till I had become about discouraged. The only good I could perceive I had done was to relieve the sour risings from the stomach, which I did with Sulphuric acid. About this time I procured a copy of Hale’s “New Provings,” and upon reading the symptoms of Sanguinaria canadensis, I said to myself, here is an exact counterpart of that troublesome “ headache case.” Upon meeting my patient a few days afterward, I said to her, “ If there was any truth in the homoeopathic law, I now have a remedy that will cure your headache,” and accordingly prescribed four pellets, to be taken night and morning, medicated with the mother tincture. She had no more attacks for upwards of two months, and then had but a very slight one. I accordingly prescribed the same remedy again, and have had no further trouble with the case.

I have since used this remedy in similar cases, and with the same success.

It has cured the following symptoms when occurring during other affections : “ A red cheek, with burning of the ears;” “ redness of the cheeks, with cough;” “cheeks and hands livid in typhoid pneumonia.” These symptoms are also found in the provings of Phosphorus, Lycopodium, Sulphur, and Lachnanthes.

No drug so surely produces intense irritation of the nasal mucous membrane, when inhaled, as the Sanguinaria. Even its internal administration causes coryza. It is not strange, therefore, that homoeopath ists have found it curative for acute and chronic coryza , also for “ loss of smell.” It has cured “ influenza, with rawness in the throat, pain in the breast, cough, and finally, diarrhoea.” This last is a characteristic peculiarity of the drug, and as many catarrhal affections tend to result in intestinal irritation or diarrhoea, the Sanguinaria should be remembered in each instance. Dr. Barton (allopathic) says he has “ heard of the application of the powdered root to a fungous tumor within the nostril, with the effect of producing detumescence, and bringing away frequently small pieces of the fungus, which, in the first instance, impeded the progress of the air through the nostril, and was supposed to be a polypus.” Dr. Smith (botanic) says: “Applied to fungous flesh it proves escharotic, and several polypi of the soft kind were cured by it.” Dr. Becker (homoeopathist) states that a

polypus of the nose ceased to grow from the time the powder of the root was snuffed. Several physicians of my acquaintance claim to have cured nasal polypi by the internal administration of the tincture of blood-root. It was used in the lower dilutions in some cases. The finely powdered root forms one of the ingredients of many of the “ catarrh snuffs” sold in the shops. It is often used as a domestic remedy for chronic catarrhal affections of the nose. Dr. D. C. Powers, of Coldwater, Michigan, was very successful in the treatment of obstinate nasal catarrhs and ozama. He prescribed the second trit. of blood-root as a “snuff,” to be forcibly inspired up the nose, and gave at the same time Sanguinaria 3d, or Nitric acid, internally. It has cured, in my hands, many cases of ulcerative oztena with epistaxis.

It is homoeopathic to catarrhal ophthalmia, granular lids, and even ulcers on the cornea. I once cured a case of the latter, very happily, by the use of Sanguinaria 3d, internally and topically. The case had proved obstinate under ordinary treatment, and I bethought me of the beneficial effect of blood-root in indolent ulcers. A wash of about the strength of the 3d dilution was prepared in distilled water, and used as a collyrium. Under its use the ulcers healed in a week, leaving but a slight opacity.

Blood-root is useful in expulsive gingivitis, in cases where the gums become very spongy, bleeding, and fungoid.

Dr. Woodyatt, Professor of Ophthalmic and Aural Surgery in this college, uses the Sanguinaria very successfully, internally and topically, for catarrhal affections of the inner ear and Eustachian tube, and for the many throat affections which are so often the cause of deafness and otalgia.

It has cured angina and a species of pharyngitis, also ulcer r ated sore throat. I have been informed by intelligent persons that they have been permanently cured of recurring quinsy, with ulceration, by using a gargle of blood-root. Upon testing it in practice I found it quite equal to Hepar sulphur in its power of preventing attacks of tonsillitis; also in actual ulcerations of the throat. The lower dilutions were used.

Dr. Thomas Nichol reports the following concerning the use of Sanguinaria canadensis in pseudo-membranous croup:

Being busy at the time I neglected contributing to the first edition of Dr.

Hale’s admirable work, though I had a few items which might have proved of interest. When I received the book, I turned at once to the article on Sanguinaria canadensis, expecting to find a dissertation on the use of this remedy in pseudo-membranous croup, and was disappointed on finding that it said nothing as to its use in this disease. In the region in which I then resided we had many cases of pseudo-membranous croup, — not the mere spasmodic variety, but the kind characterized by the deposition of a fibrinous membrane in the larynx and trachea, — and the mortality has been very great. Under allopathic treatment — the usual routine of purgatives, emetics, blisters, bleeding, and Calomel — almost every case died ; and even under homoeopathic treatment, aided by the appliances of the so-called hydropathy, the mortality was, perhaps, 25 to 30 per cent. I had tried in succession everything suggested in our works on therapeutics, from the orthodox Aconite, Spongia, and Hepar s., of Hahnemann, to the apparently heterodox application of Nitrate of silver to the larynx, recommended by Dr. Marcy in the first edition of his work on practice, and the result was as I have stated.

Despairing of help from our treatises on therapeutics, which, after all, merely present to us the views and experience of one man, and calling to remembrance the grand lessons taught me by Dr. Constantine Hering, I applied myself specially to the study of the homoeopathic Materia Medica, and guided by the star of similia I decided that Sangu inaria canadensis possessed, both in its symptoms and in what Professor Walter Williamson calls “the run of the remedy,” all the properties which would make it a true remedial agent in this disease. The symptoms which guided me were : “ Chronic dryness in the throat and sensation of swelling in the larynx, and expectoration of thick mucus. Aphonia, with swelling in the throat. Continual severe cough, without expectoration, with pain in the head and circumscribed redness of the cheeks. Tormenting cough, with exhaustion and circumscribed redness of the cheeks. Croup.” Shortly after I was called to a case of true croup, and having no preparation of the Sanguinaria in my office I gave minute doses of the pure Sanguinarin in a little water, giving an occasional dose of Aconite, and the result was most gratifying ; and I was equally successful in a number of cases, to the diagnosis of which I paid great attention.

I am in the habit of regarding the literature of the eclectic school of medicine as being a vast mine of gems and precious metals, which can be best explored by the conscientious physician, lighted by the torch of the similia, and in the course of my studies I perused Professor Paine’s “ Epitome of Eclectic Practice,” and his testimony is as follows : “ The Sanguinarin is one of the most valuable remedies known in the treatment of pseudo-membranous croup. It has proved as much of a specific for that disease as Quinine has for ague. I have seen it used in a great number of cases, and have never known a single failure. It should be made into an acetic syrup, by adding twenty grains of Sanguinaria to four ounces of vinegar ; steep, and add one ounce of sugar to form a syrup. Dose, one teaspoonful as often as indicated.” I have frequently given the remedy in the form of an acetous syrup, as Professor Paine directs, though I found the dose he mentions to be far too large, and I found that one grain, or even less, in two ounces of vinegar, to be a better preparation. I have seen better results from the acetous

preparation than from the watery, and I refer those who may object to using vinegar in preparing the Sanguinaria to the fact that Hahnemann gave his infinitesimal doses of Opium to scarlatina patients in beer. (Essay on the Cure and Prevention of Scarlet Fever, in “Lesser Writings,” page 375.) I regret that I kept no note of the greater number of my cases, but I give the record of one of the cases I attended lately.

On February 17tli, 1866, I was called to see W. G., aged five years. He had been from home visiting some friends, fourteen miles distant, when he was taken sick. An allopathic physician, who had been called in, pronounced it a case of pseudo-membranous croup, advising a local application of Nitrate of silver to the larynx, but the mother preferred to hurry home and trust him to homoeopathy. I found him with a hoarse muffled cough, complete aphonia, and the pulse was 132. On examining the fauces I found the soft palate and fauces covered with a continuous coating of pearly fibrinous exudation, and on auscultating the larynx the characteristic hissing sound was heard. The difficulty of breathing was very great; the child stretched back his head and grasped his throat in his agony, while the dark and swollen features added to the gloom of the prognosis. I commenced with the Sanguinaria, as directed above, and in fifteen hours the symptoms had undergone a notable modification ; and in forty-eight hours the patient was out of danger. No other remedy was used, except an occasional dose of triturated Aconite, as became a rigid Hempelite.

1 have also found Sanguinaria a leading remedy in tracheitis ; and in the July number of the “ American Homoeopathic Observer ” I recorded seven cases of diphtheritic croup successfully treated by this remedy.

By reference to the “ gastric symptoms,” as well as the above, it will be seen how closely the symptoms simulate those of Arsenicum, Phosphorus, and Tartar emetic. It will cure, according to Dr. Tully, ‘‘atonic, subacute, and chronic inflammations of the stomach.” No remedy, however, is more decidedly homoeopathic to acute gastritis. We have the terrible burning, the unquenchable thirst, the pain, vomiting, and prostration which mark that disease. In acute gastritis, the sixth or thirtieth should be used. In chronic gastritis the lower dilutions may be as useful. It ought to be useful in ulceration of the stomach.

Blood-root is fully indicated for nausea, or vomiting from irritation of the coats of the stomach. Allopaths have cured vomiting of food, or bilious vomiting, with small doses of the tincture. It is doubtless homoeopathic to many functional and organic diseases of the stomach, and I would suggest its use in gastric disorders not amenable to the ordinary remedies. Dr. F. W. Hunt, in an article on “ Dyspepsia, or Diseases of the Stomach,” thus speaks of the virtues of Sanguinaria canadensis :

This is one of the most important remedies for various diseases of the stomach, throat, liver, lungs, etc. In almost every form of indigestion, for many years, it has given me satisfactory results. It is especially useful in deficient gastric secretion, with loss of appetite and periodic nausea ; heartburn, nausea, and irregular chills ; torpid state of the liver ; dyspeptic headache, terminating by regurgitation and vomiting of bitter greenish fluids ; soreness in the abdomen, increased by eating; feeling of heat in the stomach ; chronic gastritis ; red tongue, which burns as if from contact with something hot; lips red and dry; throat hot and dry ; tickling at the entrance of the larynx, which excites cough ; cough peculiarly severe, not relieved by expectoration, with pain in the chest and redness of the cheeks. When digestion is imperfect from deficiency of the true gastric fluid, when the food undergoes chemical decomposition, and gas is evolved in large quantities, Sanguinaria will generally change the action of the stomach, and digestion becomes more complete. When the mucous membrane is congested the flatus formed by fermentation is retained by a spasmodic constriction of the cardia. Its irritation is reflected through the pneumogastric nerve upon the lungs, exciting a feeling of “tickling” in the entrance of the trachea, with sympathetic cough. This peculiar, dry cough does not yield to expectorants, but often persists for hours, and is only relieved by eructations. Aromatics and stimulants fail to expel the gas. They only increase the erethism of the coats of the stomach. The Sanguinaria affords a better resource. It not only relaxes the constricted cardia, permitting the flatus to escape, but excites a healthy, homoeopathic reaction on the whole surface of the fauces, oesophagus, and stomach, superseding the morbid state by a healthy one. Dr. Coe and others (allopathists) caution against the use of blood-root when there exist “gastritis and enteritis, and whenever we have occasion to suspect ulceration or abrasion of the mucous surfaces of the bowels.” This caution suggests to the homoeopathist that the medicine will cure such conditions, if administered in dynamic doses.

Dr. Fairbanks, of Chicago, reports the case of a patient, a woman, agerl fifty -six, who had been subject to pyrosis, a rising of burning corrosive fluid from the stomach, with flatulence, for twenty years. She now gets prompt relief from the first attenuation of Sanguinaria, in pellets. It is the only remedy that will arrest a paroxysm.

Eclectic physicians claim that Sanguinaria has a specific action on the liver. The hepatic symptoms in the provings were collected from allopathic sources : Barton, McBride, and Tully. It is doubtful if they should have a place in the provings at all, as by reference to the original it will be seen that they were mere assertions of the above-named physicians, and not pathogenetic symptoms. It may not be amiss, however, to quote the statements of eclectics on this point. King says it has been used successfully in “jaundice and other hepatic affections. In torpid conditions of the liver it is very valuable.” Jones asserts that it

“arouses the liver and glandular system in general.” Coe admires it in “ all cases of hepatic torpor, jaundice, biliary concretions, chronic hepatitis, etc.” A curative symptom in the pathogenesis would seem to point to the spleen as the diseased organ, although it may have been the lung, or even a myalgic affection, accompanied with cough. It is said to have cured “ indurations of the abdomen,” but no details are given, nor the name of the observer, and consequently we are at a loss to know the character of the indurations.

The blood-root does not generally purge unless given in large doses, hence it will not be found often indicated in diarrhoea. There is one variety of diarrhoea, however, in which it has been found curative by Dr. Bute, namely, “with the diarrhoea, termination of the coryza and catarrh,” also, “ the affection of the breast always ended with the feeling as if hot water were poured from the chest into the abdomen, which was followed by a diarrhoeic stool.”

The “ dysentery,” marked as curative in the original proving, is merely an observation of Rafinesque (botanist). Some dysenteric symptoms, however, are found in the pathogenesis, which may be made use of.

Dr. Bute asserts its curative power in haemorrhoids , but gives no special indications, nor do we find any in the proving. The last symptoms under “ stool” would seem to be misplaced. It denotes either an affection of the left ovary, or was simply a myalgic pain.

Take it all in all, the so-called proving of Sanguinaria, as made up for the “ Transactions of the American Institute,” cannot be considered a commendable production. Some of the most notable of the symptoms marked (curative) were the mere assertions or theoretic deductions of allopathic observers, not verified by homoeopathic physicians. I would advise the student or physician, before he attempts to use this drug upon the information obtained in that proving, to study the original, and judge of its merits for himself.

The first curative symptoms belonged originally to the following group reported cured by Dr. Bute, namely :

In a lady, pain in the left hypochondrium, which was rendered worse from coughing, but was better from being pressed, and by lying on the left side ; very copious urination at night.

The whole group of symptoms may have been of renal origin.

According to Dr. Coe, Sanguinaria is very useful in many functional disorders of the kidneys.

Our provings are, however, too meagre to give us any clue to its action on those organs. I cannot ascertain who reported the curative observation of “gonorrhoea” Dr. Coe advises it for chancres, buboes, secondary and tertiary syphilis, but says nothing of its use in gonorrhoea, nor does any other writer. I can readily imagine it might be useful in phagedenic chancre, used internally, and as a topical application.

It has been used successfully in amenorrhoea , especially when the head suffers from the non-appearance of the menses.

Dr. O’Connor (allopathist) writes :

For the last twelve years I have used Tincture of sanguinaria, exclusively, in cases of amenorrhoea, and have recommended it to others, who speak favorably of its effects. In that time I have treated as many cases of this disease as usually falls to the lot of a village practitioner, and as yet have no cause to find fault with the efficiency of the remedy. I consider it superior to Eberle’s great remedy, the Tincture of polygonum hydropiper. I commence a fortnight before the expected return of the menses, and give teaspoonful doses of the tincture, three times a day, and a teaspoonful on going to bed (preceded by a warm foot-bath). If the secretion is not restored at the time, I remit the use of the remedy for a fortnight, and proceed as before. When the full effect of the remedy is produced, it is characterized by slight nausea :, pains in the loins, extending through the hypogastric and iliac regions, as well as down the thighs. These symptoms sometimes manifest themselves once or twice before the discharge is completely established.

The symptoms which I have placed in italics are worthy of being noticed, as purely pathogenetic. I esteem the blood-root a good remedy in suppressed menses, but chiefly indicated when the suppression has been followed or preceded by pulmonary disease. Its use in such cases has generally been attended with good results.

Dr. Miller (eclectic) advises it in dysmenorrhoea, when occurring in torpid subjects, but says it is “contraindicated in patients of plethoric habit.” This would indicate to us that it would be primarily homoeopathic to dysmenorrhoea with plethora, and in dysmenorrhoea when the menses are too frequent, also when there is a tendency to congestion of the brain or lungs.

It is homoeopathic to threatened abortion, when the symptoms mentioned by Dr. O’Connor are present, accompanied by some

haemorrhage. It is used for a criminal purpose in domestic practice, and by unprincipled physicians.

Dr. Bute reports the following case cured by the blood-root : “ A female, who had distension of the abdomen in the evening, and flatulent discharges, per vaginam, from the os uteri, which was constantly open, at the same time a pain passing in rays from the nape of the neck to the head.” This was probably an instance of that rare disease in which the lining membrane of the uterus secretes a gas. Dr. Bute also reports cases of affections of women at the climacteric 'period, characterized by “ burning of the palms of the hands and soles of the feet, compelling her to throw the bedclothes off the feet for the purpose of cooling them.” Used internally and topically (by injection) it has cured ulcerations of the os uteri, corrosive and fetid leucorrhoea, and polypi of the uterus.

Sanguinaria has always had an extensive reputation for the cure of cough. The aborigines of the Eastern States often astonished the early settlers by the cures they effected with this remedy. It is said that the most obstinate coughs disappeared during the use of the blood-root. The physicians of an early day seem to have used blood-root more frequently than their successors, 11afinesque, Barton, Tully, and others, all assert its great curative power in many varieties of cough.'- They even assert its power to cure pulmonary consumption. Besides the above curative symptoms, the following are reported: “ Cough, with coryza; then diarrhoea;” “tormenting cough, with expectoration and circumscribed redness of the cheeks.” Several instances have come under my observation where the blood-root really appeared to cure incipient phthisis.

Eclectic physicians use it in thoracic diseases where the allopath considers Tartar emetic indicated. In this they are not far from the truth. Sanguinaria, in affections of the lungs, occupies a place midway between Phosphorus and Tartar emetic. It has many symptoms in common with both, and others possessed by neither. I have used the blood-root for many years in bronchitis, pneumonia, and other diseases of the respiratory organs, and have obtained from it some very satisfactory results. In the massive doses of the old school, given to nausea and emesis, it was productive of great injury, but in dynamic doses its use is never attended with any aggravations ; a few drops of the mother tincture may be used in some chronic affections of the pulmonary organs, while in acute diseases, with a high grade of irritation, the 3d is the safest and best attenuation. In the majority of cases of pneumonia, there occurs a group of symptoms for which we have generally used Phosphorus or Sulphur with good results, although the convalescence under those remedies was apt to be lingering. But when those symptoms and conditions are met with Sanguinaria, 2d dilution (decimal), or Sanguinarin, 4th trit., a rapid subsidence of the diseased action occurs. At the second, and during the existence of the third stage of inflammation, we have, as physical signs, dulness on percussion, bronchial respiration, etc., denoting the presence of red, or even gray hepatization, and purulent infiltration of the pulmonary parenchyma. Watson considers it doubtful whether recoveries take place from the third stage of pneumonia; but under homoeopathic treatment I do not believe such recoveries impossible. The general symptoms indicating Sanguinaria are extreme dyspnoea, short, accelerated, constrained breathing, the speech ceases to be free, the sputa becomes tenacious, rust-colored, and is expectorated with much difficulty. The position of the patient is upon the back ; there is not much pain in the chest unless the pleurse are involved, and then it is of a burning, stitching character. The pulse is quick and small, the face and extremities inclined to be cold, or the hands and feet burning hot, with circumscribed redness and burning heat of the cheeks, especially in the afternoon. Under the use of this remedy the dyspnoea subsides, the bronchial breathing disappears, we hear afresh the small crepitation, first alone, then mixed with the natural respiratory murmur, which in its turn becomes alone audible. The sputum becomes again less tenacious, less red, but yellow and more like the expectoration of catarrh, and is expectorated in large, heavy masses; the febrile symptoms gradually abate, and a favorable convalescence is established. I give the medicine every two hours, generally alone, but occasionally in alternation with Phosphorus or Tartar emetic. In its powers over chronic bronchial or laryngeal coughs it rivals Lycopodium and Sulphur. It relieves, and often cures, “coughs with chronic dryness in the throat, and sensation of swelling in the larynx ;

continual severe cough without expectoration, with pain in the breast and circumscribed redness of the cheeks;” “ cough, with coryza, then diarrhoea.” This last symptom is an important indication for the use of Sanguinaria. After a severe cold or undue exposure, some persons are attacked with coryza, catarrhal headache, severe pains in the chest, with tightness of breathing, and dry, harassing cough, all of which subside upon the recurrence of diarrhoea. In such cases Sanguinaria is eminently indicated, as it causes a similar group of symptoms. Dr. Morrow" praises it very highly in haemoptysis. In one case which came under my observation it seemed to correct the bleeding promptly. Cases have been reported to me where the tincture of blood-root cured spitting of blood which had resisted other means. It will undoubtedly be found useful in some cases of asthma, croup, laryngitis, and perhaps pleurisy , but we have no homoeopathic testimony of its effects in those diseases.

Dr. Wolff claims to have used the 200th potency with success in “syphilitic pulmonary inflammation.”

Dr. Tom Nichol, of Montreal, writing of its use in acute oedematous laryngitis, says :

In the sixth volume of the “ American Observer ” will be found an essay on acute cedematous laryngitis by the writer, in which he said : “ I have never had an opportunity of testing the virtues of Sanguinaria in this disease, but would expect considerable from it.” I have lately had the long-looked- for opportunity, and hasten to lay the results before the readers of the “ Observer.”

On Friday, April 17th, I was called to Mrs. C., aged fifty-nine, who had been complaining for some few days. I found an inflammation of the cervical glands of the right side, involving the parotid gland to a limited extent, and accompanied by extensive inflammation of the subjacent cellular tissue. The parts were hot, tender, swollen, and red, — in fact, the well known calor, dolor, tumor, rubor, — and there was reddening of the fauces, with slight pain on deglutition. I prescribed Belladonna, 6th decimal trituration, and advised rest, quiet, and silence. On the following day the situation was but little changed, and Mercurius iodatus ruber, 3d decimal trituration, was prescribed.

At 6 o’clock of Sunday morning, April 19th, I received an urgent call to the patient, who, I was told, had hardly been able to breathe all night. I found her sitting up in bed, with a characteristic sawing and rasping sound issuing from the larynx — a sound somewhat difficult of description, but which once recognized can never be forgotten. The tonsils and pharynx were swollen, but auscultation showed that the sawing and rasping sound issued from the larynx. The cough was dry and harsh, relieved by sitting up in bed, aggravated by eating and lying down, and it was accompanied by difficult expectoration of tough and glairy

mucus. The voice was low and suppressed, and it was with difficulty that I could make out the hurried, whispered sentences. The pulse was feeble and fluttering, and the lips were pale ; but on both sides of the cheeks there was a circumscribed redness. The pathognomonic symptoms which made the pathological state quite clear to me was the fact that expiration vms performed more readily than inspiration. M. Thuillier’s test was decisive as to the diagnosis, for “ when the forefinger was passed into the larynx, there is the perception of a cushion formed by the tumefaction of the sides of the glottis, a soft, pulpy body, quite distinct from the ordinary hard feel of the parts.”

The diagnosis was acute cedematous laryngitis of the supraglottis variety — all the more dangerous because it was an intercurrent disease, and the peculiar respiration arose from the fact that the cedematous membrane which fills the glottis closes like a valve against the entrance of air, but readily permits it to pass out. I prescribed Sanguinaria 1st decimal trituration, a dose every half hour.

At 1 p.m. I found that improvement had commenced almost as soon as the medicine was given. The sawing and rasping sound was now much diminished, the respiration was comparatively easy, inspiration and expiration were performed with the same facility, the cough was less frequent and less severe, the voice was quite audible, and the patient had slept much of the time since morning. The tonsils and pharynx were still red and swollen, but the glottis was clear of the tense and rounded sw’ellings present in the morning. Sanguinaria was continued in the same dose.

At 7 P.M. I again saw the patient, and found that the very serious pathological state had almost, wholly disappeared. The Sanguinaria was continued all night, and in the morning, as the acute cedematous laryngitis was no longer present, treatment was directed against the inflammation of the cervical glands and cellular tissue.

I cannot leave this medicine without calling attention to the relationship between it and Chelidonium. It belongs to the same botanical family. Its chemical constituents are similar. Both contain Chelidonin ; both affect the liver, the right lung, and the right side of the head. Both have throbbing in temporal arteries ; and in both the headache and prosopalgia are periodical.

It would seem that the Chelidonin common to both plants was the agent which caused the above group of symptoms.

Chelidonium has no Sanguinarin in its composition. The former is the agent which most profoundly affects the liver ; the latter seems to affect both lungs more intensely than the former, and has greater influence over the circulation, as in haemoptysis.

I cannot omit Dr. Farrington’s comparisons of these two remedies, which, although not ascomplete aslshould like, will prove an excellent guide to their administration and their differential diagnosis.

SANGUINARIA.

MIND,

Anxiety ; must move about ; weeps and knows not why.

Headache from occiput to forehead, over right eye; periodical (Hale).

Occiput so heavy he can hardly lift his head; pressure to the left ear; head worse from sneezing, stooping, open air ; better from eating (F.).

EYES, FA

Pupils contracted.

Profuse lachrymation with neuralgia, using eyes, and as a result of fistula lachrymalis.

Rushing as of wind out of the ears. Deafness during cough.

Mostly dry coryza, one side obstructed ; or fluent, with thick blood in the morning.

Face yellow ; gray, sunken, blue around the eyes. Face dark red in pneumonia, capillary bronchitis.

Supraorbital neuralgia; worse right side ; copious lachrymation.

HEAD.

Anxiety; irritability; cannot bear to hear persons walk across the room.

Headache from occiput to forehead, over right eye; periodical; worse from noises, light, stooping, motion, eating ; better from lying still and after sleep.

JE, EARS.

Pupils dilated.

Burning lachrymation as a symptom of catarrh, coryza, raw throat, cough, diarrhoea.

Tinnitus from congestion ; earshot ; oversensitive to noises.

Mostly fluent right-sided coryza ; hot discharge, eye waters, throat raw, finally diarrhoea. Polypus.

Face pale, swollen around the eyes ; bright-red circumscribed cheeks ; or livid in typhoid pneumonia. Veins swollen.

Supraorbital right-sided neuralgia; relieved only by holding the head tight to the floor.

MOUTH, THROAT.

Toothache, worse in bed, better from cold water.

Tongue narrow, pointed (dyspepsia), furred.

Taste bitter ; food tastes natural.

Toothache, decayed tooth, worse from cold drinks.

Tongue as if scalded ; coated white (loss of appetite).

Fatty, slimy taste ; sweets taste bitter.

On the throat the two remedies have but little similarity of action. Chelidonium inflames the fauces, but, as will be seen, its main action is on the larynx. Sanguinaria, on the other hand, causes ulceration of the mouth and fauces. Mouth, gums, and roof sore, burning ; throat feels as if scalded, tonsils swollen, worse the right ; pearly diphtheritic exudation ; worse from swallowing sweets ; throbbing in the head, red cheeks ; distended temporal veins.

SANGUINAEIA.

STOMACH, ABDOMEN.

Longs for milk, hot drinks, coffee ; they agree.

Aversion to cheese, boiled meats.

Gastralgia, with gnawing pains in the stomach, made better from continued eating.

Hepatic congestion, with sharp stitch pains ; pains under the right scapula ; clay-colored or bright-yellow, thin stools; colic from portal congestion, with great heat, contraction of the navel ; headache behind the eyes and in occiput.

Stool bright-yellow, thin ; or dry, in hard lumps ; white, clay-colored.

Loss of appetite, with craving for piquant food.

Aversion to butter.

Gastric catarrh, burning; tongue and lips red ; throat hot ; eating relieves the sensation of nausea.

Hepatic symptoms less marked ; like a hot stream from breast to liver ; yellow stools less characteristic than in Chelidonium; colic, with much flatulence and torpor of the liver ; sick headache over the right eye ; nausea, vomiting of bile.

Stool yellow, thin, undigested ; much offensive flatus ; terminates the catarrh.

URINE, GENITALS.

Sharp, spasmodic pains in the kidneys and bladder ; urine greenish (bile), or deposits red sediment.

Menses too late, profuse and last too long ; pain under angle of right scapula.

Burning in the vagina periodically at the same hour.

Milk vanished.

Pain in the left hypochondrium, with copious, pale urine ; urine yellow (bile) ; reddish sediment.

Menses too early ; black, offensive blood ; sick headache, from occiput over right eye.

Discharge of flatus from the vagina ; climacteric changes.

Nipples sore, burn.

LARYNX, CHEST.

Hoarse periodically every day, 5 p.m. ; dry, hard, spasmodic cough, as from dust in the larynx ; spasm of the glottis in expiration; constriction across the upper part of the larynx ; worse in the morning (cough).

Aphonia, with swollen larynx ; rawness, burning; ulcers; dry cough, ceases when flatus is passed up and down, or as soon as diarrhoea ensues ; wheezing, whistling cough; worse at night and lying with the head low.*

• Sanguinaria corresponds more to inflammation and ulceration ; Chelidonium offers more spasmodic symptoms. Sanguinaria, with its peculiar cough, has cured croup (J. B. Bell), and is similar in pseudo-membranous croup to Kali bich. (Nichol.)

LARYNX

Pneumonia or capillary bronchitis, with bilious complications; loose rattling cough ; bright -yellow, thin diarrhoea; in severe cases, dark-red cheeks, great dyspnoea, with fanlike motion of the alse nasi, one hot and one cold foot.

Heart beats so forcibly as to raise the clothing (bilious complaints).

Pulse full, hard, but not much accelerated ; or small and rapid (capillary bronchitis).

SANGUINARIA.

:, CHEST.

Pneumonia, with marked vascular disturbance ; rust-colored sputa ; little pain or simply burning ; circumscribed red cheeks ; great dyspnoea ; in severe cases, livid face and hands ; quick, small pulse, weak feeling at the heart; extensive hepatization.*

Palpitation violent, felt in the head, constriction of the stomach, deathly nausea.

Pulse frequent, full ; or quick, small ; frequency and force reduced (pneumonia).

BACK,

Pain under the angle of the right scapula.

Rheumatism not so well marked as in Sanguinaria. Tearing pains, parts will not bear the least touch ; sweat gives no relief.

Nails blue, joints of the fingers yellow, cold.

One foot cold, one hot (pneumonia).

LIMBS.

Pressure and pain along the inner border of the left scapula.

Rheumatism, especially of the right deltoid, muscles of the back ; parts sparsely covered are sensitive to touch ; sweat relieves the pains ; pains shift. f

Livid hands (pneumonia) ; roots of the nails ulcerate one after the other.

Feet generally burn.

Sleepy, yet cannot get to sleep.

SLEEP.

Restless, dreamy sleep ; awakens frightened, as if falling.

FEVER.

Irregular circulation ; dark-red face ; j Irregular circulation ; hectic red cheeks ;

one cold, one warm foot ; one ear | cold, one warm ; palms hot ; veins : of hands and arms swollen.

hot streaming from chest to abdomen ; flushes of heat at climaxis ; feet, hands burn ; veins swollen, especially temples.

• It is now known that one great danger in pneumonia is heart failure. The symptoms of Sanguinaria point to its use in just such an emergency.

f Sanguinaria is an excellent remedy in acute rheumatism, worse from motion, at night; pains are throbbing, burning, and there are spasmodic pains in the joints. When metastasis to the heart occurs from external application to the affected joints, Sanguinaria or Kalmia (according to Hering) will be of great service.

FEVER.

Chilly in the open air, even in summer. Heat with the colic ; heat with dark-red cheeks ; cold feet ; short breath ; nausea.

Sweat ceases on waking.

Chilly and hot alternately.

Flushes of heat; hectic with bright-red cheeks ; nausea, sick headache ; dyspnoea.

Profuse sweat ; cold sweat.

GENERALITIES.

Itching, with jaundice.

Old, putrid, spreading ulcers (Lippe).

Itching precedes the nausea.*

Indolent ulcers, no pain, dry, sharp-cut edges (W. Wesselhoeft).