Gelsemium sempervirens

Volume I — Special Symptomatology

(Yellow Jessamine.)

Botanical Description. — This plant is likewise known by the name of Field Jessamine and Woodbine; it is the Bignonia Sempervirens of Linnaeus, and the Gelseminum nitidum of Michaux and Purch. It is named the Gelsemhm nitidans by some authors. It has a twisting, smooth, glabrous stem, with opposite, perennial, lanceolate, entire .leaves, which) are dark above, pale beneath, and which stand on short petioles; the flowers are yellow, having an agreeable but rather narcotic odor, and stand on axillary peduncles; the calyx is very small, with five sepals; the corolla is funnel-form, with a spreading border, and five lobes, nearly equal ; stamens, five; pistils, two; capsules, two-celled, compressed, flat, two-partible; seeds flat, and attached to the margins of the valves. The berries are black.

This is one of the most beautiful climbing plants of our Southern States, ascending lofty trees, and forming festoons from one tree to another, and in its flowering season, in the early spring, scenting the atmosphere with its delicious odor. On account of its gorgeous yellow flowers, and the rich perfume which they impart, as well as the deep shade it affords, it is exten. sively cultivated in the gardens of the South, as an ornamental vine. It grows in the North as an exotic. It begins to blossom about the first of March, and its blossoming season lasts until the end of May. The root is several feet in length, with scattered fibres, and varies from two to three lines in diameter, to nearly two inches. The internal part of the root is woody, and of a light yellowish color, the external part or bark, in which the medicinal virtues are said principally to reside, is of a light snuff color, and from half a line to three lines in thickness.

A vine, the root of which is sometimes gathered for the Gelseminum, resembles it very much in appearance, though it is of a lighter color, and the outer bark is covered with white specks or marks somewhat similar to those on young cherry or peach limbs, and the lower part of old vines becomes rough and have small tendrils that fasten upon the bark of trees, and which are never seen on the Gelseminum. The bark of the vine is also more brittle, and the leaves are always on long footstalks which are oppo. site, at the end of which are two opposite leaves, almost exactly resembling the Aristolochia Serpentaria. The root is almost white, very tough, straight, and about the same length of the medicinal root, and has a slightly bitter, disagreeable, nauseous taste. I never saw any of the flowers, though they are said to resemble the others in shape, but are snowy white, with a slight unpleasant odor. The plant is called the White Poison Vine and White J essamine.

I am thus particular in giving a correct description of this plant, in order that there shall be no mistake about the matter. Homoeopathic pharmaceutists above all others, should be scrupulously careful to prepare

*The correct botanical name of this plant is probably Gelsemium nitidans, but I have retained the name by which it was first known to the profession. (Hale.)

the medicines we use in their utmost purity. The Gelseminum, more than any other vegetable remedy, demands the most careful preparation. It is not known to me whether the leaves possess any medicinal qualities; but I should suppose from analogy that they possess as much comparative power as the leaves of Aconite or Veratrum viride. The tincture made from the flowers is comparatively inert.

Officinal Pkepakations. — Tincture of the fresh bark of the root; dilutions.

Analogues. — Aconite, Agaricus, Belladonna, Conium, Cimicifuga, Hyoscyamus, Chloral, Iberis, Lachnanthes, Opium, Rhus, Stramonium, Solanum. Mental Sphere.

• Dullness of all the mental faculties {primary).

• Anxiety; incoherency of thought, aversion to study. Melancholy and desponding mood.

• Excessive irritability of body and mind [secondary). 0 Nervous excitement of hysterical patients.

0 Stupid, comatose conditions attending typhoid fever. 0 Hysterical conditions in plethoric subjects.

Head.

Pain in the head, over the eyes, and across the forehead. Excruciating headache, accompanied by slight nausea; pain

slightly mitigated by shaking the head. Pain most frequently in the forehead and temples. ° Band-like pain surrounds the head, with shooting pains in

each jaw.

Pain in the head constant, dull, stupefying and pressive. Head feels light and large, with vertigo.

0 Dull, dragging headache, mainly in the occiput, mastoid, and upper cervical region, extending to the shoulders; relieved when sitting by reclining head and shoulders on, a high pillow.

0 Congestion of the brain in children during dentition.

0 Nervous headaches, from emotional excitement, etc.

0 Hemicrania, with dimness of sight and double vision.

Giddiness, a constant symptom.

0 Headache, extending from the occiput to the os frontis.

0 In the morning on rising a dull pain in the head and a slight

tendency to throbbing in right side of head. ° A settled, dull, dragging headache, mainly in the occiput,

mastoid, and upper cervical region, extending to the

shoulders, relieved when sitting by reclining the head and shoulders on a high pillow.

° Headache, coming on suddenly, with dimness of sight or double vision, with dizziness followed by great heaviness of the head, semi-stupor, dull, heavy expression of the face, great vascular reaction, full pulse, etc. Cramp-like pains of drawing or tearing character, aggravated by study or exertion, following fever and ague.

"Headache (neuralgic) after cerebro- spinal meningitis; "a terrible neuralgia, commencing in the upper portion of the spinal cord, proceeding thence gradually through the upper portion of the cerebrum, and terminating in a bursting pain in the forehead and eyeballs, with aggravation about 10 a. m., worse when lying down, with nausea, vomiting, cold sweat on forehead, and cold feet; vertigo and obscuration of sight on stooping; a sensation as of a hand drawn tightly around the head above the ears, and soreness in scalp and brain; the vertebrae prominens and cervical vertebrae sensitive to pressure. (Cured by Gelseminum 200^, three times a day.) " [Dr. C. C. Smith.)

0 A. relapse of the same patient, with the additional symptoms, viz.: lameness and stiffness of neck; on waking at night retraction of head backward, relieved by bending head forward; frequent urging to urinate, with partial loss of power in the sphincter vesicae; heat in palm of hands and itching all over the body, preventing sleep; after scratching, a raw sore, surrounded with blisters, would appear. (These symptoms were also cured by Gelseminum 200.) Periodical hemicrania (over one eye).

Eyes.

• Great heaviness of the lids; difficulty of opening or keeping

them open.

• Fullness and congestion of the lids.

• Diplopia when inclining the head toward the shoulder.

• Misty or glimmering appearance before the eyes.

• Distant objects seemed indistinct as I rode or walked.

• Dilatation of the pupils; amaurosis; diplopia; blindness;

dimness of sight.

Sense of sight tardy in following the movements of objects.

• Pain in both eyes, particularly the left, with dimness of sight. c Inflammation, with great flow of tears at intervals.

Total blindness, with violent dizziness. ° Asthenopia; amaurosis.

Disturbance of the power of accommodation, similar to Calabar, Chloral, and analagous drugs.

Ears.

• Hushing and roaring in the ears.

• Sudden and temporary loss of hearing. Digging in the right ear; also, stitches.

° Neuralgic otalgia, especially when periodical. "Earache from a cold; (internally, also a drop or two on cotton put in the ear).

Nose.

• Watery discharge from the nose, with sneezing in morning.

• Tingling in the nose; bloody, mucus discharge.

0 Colds in the head, with fluent coryza from the nose, hoarseness, cough, soreness of the throat and chest. 0 Epistaxis, with suppressed menses. 0 Acute coryza, with dull headache and fever. ° Hay-fever, with morning sneezing.

Face.

• Erythema of the face and neck.

• Sensation of stiffness in the muscles of the jaws.

0 Facial neuralgia, with or without contractions and twitchings

of the muscles. 0 Orbital neuralgia, periodic, every day at the same hour. Papulous eruptions of the face. 0 Trismus.

Mouth and Throat.

• Stiffness of the jaws; difficulty of opening the mouth. 0 Pains of a shooting character in the jaws.

Dryness of the mouth; thickly coated tongue.

• Tongue red, raw, and painful.

• Partial paralysis of the glottis and tongue. Irritation and soreness of the fauces.

• Paralytic dysphagia.

• Painful sensation of something having lodged in oesophagus. ° Spasmodic sensation and cramp-like pains in oesophagus.

° Oesophagitis (catarrhal), a not rare affection. {Hale.)

0 Tonsillitis, from acute catarrh.

0 Spasmodic affections of the throat.

° Spasmodic croup (catarrhal), with high fever.

Thirst during the sweat, clammy, feverish taste.

Great hunger ; eructation ; nausea.

Yellowish-white coating of the tongue, with foetid breath.

Stomach.

• Feeling of emptiness and weakness in the stomach and

bowels.

Distension, with pain and nausea.

Rumbling and dull pain in the epigastrium, relieved by expul.

sion of flatus. 0 Sensation of weight in the stomach, with dull pain.

Abdomen and Stool. Rumbling and roaring in the abdomen, with emissions of

flatus above and below. Periodical pains in the abdomen, with yellow diarrhoea in the

evening.

Bowels loose, but great difficulty in discharging anything. Severe griping in the lower abdomen; no relief till discharge

of large, deeply bilious discharges. ° Slow stool, leaving a sensation of more remaining to be

passed, and of abdominal repletion. ° Spasmodic and flatulent colic.

° Acute enteritis (catarrhal), during cold, damp, or hot, damp weather.

° Neuralgia of the intestines, periodic, malarial. ° Diarrhoea, from exciting emotions; sometimes involuntary. ° Diarrhoea of soldiers from mental and moral excitement. 0 Dysentery (epidemic), malarial or catarrhal. ° Paralysis of the sphincter ani, with involuntary diarrhoea, the result of nervous excitement.

Liver.

Bilious diarrhoea, of the color of green tea {primary). Jaundice, with prostration, clay -colored stool, etc. {secondary).

Deficient secretion of bile (secondary).

0 Passive congestion of the liver, with dimness of sight, vertigo, and fullness of the head.

Urinary Organs. Urine much increased in quantity.

• Frequent urging, with scanty emission, and tenesmus of the

bladder.

• Enuresis, from paralysis of the sphincter, in children at night. ° Spasm of the bladder, with alternate dysuria and enuresis.

• Profuse urination, with relief of the headache.

° Constant, involuntary discharge of urine every fifteen minutes.

0 Paralytic conditions of the sphincter muscles of the bladder. 0 Acute catarrhal conditions of the bladder and uterus. Generative Organs.

Female. — * Dysmenorrhoea of a neuralgic or spasmodic character.

• Cramps in the abdomen and legs during pregnancy.

° Convulsions during pregnancy, with complete unconsciousness.

° Convulsions (apoplectiform) during labor.

° False pains before parturition.

0 Rigid os uteri during confinement.

° Menorrhagia (?) (from lack of contractility).

0 Inefficient labor-pains from uterine inertia.

Sensation of heaviness in the uterine region, with increased

leucorrhoeal discharge. Male. — * Involuntary emission of semen without an erection. 0 Seminal weakness from irritability of the seminal vesicles. " Spermatorrhoea from relaxation and debility. 0 Gonorrhoea, in the acute stage; great pain, inflammation,

and scanty discharge; (one of the best remedies.) {Hale.) 0 Suppressed gonorrhoea, with fever, rheumatism, orchitis, etc.;

(it will restore the discharge very soon, with abatement

of all the other symptoms). (lb.)

• Sweat of the scrotum, warm. (Iloyne.)

Larynx and Trachea. Paroxysms of hoarseness, with dryness of the throat.

Cough from tickling and dry roughness of the fauces. ° Soreness in the chest when coughing. 0 Acute catarrhal bronchitis.

0 Severe cough ; pain in the chest; tenderness in the epigastrium, with vomiting in the paroxysms.

° Spasmodic croup, (laryngismus stridulus).

0 Periodic aphonia; loss of voice only during the menses; (cured with the third dil.) {Meyhoffer, Diseases of Organs of Respiration, Vol. J.)

Chest.

• Constrictive pain around the lower part of the chest. Paroxysmal pain in the upper part of right lung, when taking

a long breath. ° Periodical pains in the pectoral muscles.

Heavy and labored respirations; expirations sudden and forcible.

0 Forming stage in pneumonia. ( Veratrum v.) 0 Convulsive, spasmodic cough. 0 Slow breathing and slow pulse.

Heart.

• Stitching sensation in the region of the heart.

• Feeling as if the heart would stop beating if she did not

move about.

• Pulse frequent, soft, weak, almost imperceptible. Fluttering pulse; pulse full, 120; pulse slow and full, or slow

and soft.

Sensation as though the blood had ceased to circulate; pulse

reduced from 112 to 56 in twelve hours. Heart's action slow and feeble; the beats of the heart cannot

be felt.

The action of the heart and arteries much depressed, with cold hands and feet; chills and pains in the head.

A sensible motion of the heart as though it had attempted its beat, which it failed fully to accomplish, and the pulse then each time intermitted, worse when lying down in bed, especially when lying on the left side. ( Wells.)

0 Excessive action of the heart from plethora, congestion, neu ralgic or rheumatic irritation, or hysterical palpitation.

Back and Neck. Dull, aching pain in back, extending up to the occiput. . Pains in the neck, like those of cerebrospinal congestion. ° Chilliness and chills running up the back. ° Myalgia of the cervical muscles. 0 Congestion of the spinal cord and cerebellum.

Upper Extremities.

• Severe pain in both extremities, deep-seated in the muscles. Severe aching pain in left elbow.

0 Rheumatic pains in extremities.

Arms become powerless; loss of voluntary motion.

Coldness of the wrists and hands.

Lower Extremities.

• Deep-seated, aching pains in bones and joints of extremities.

• Paroxysmal pain in the lower extremities.

Pains in left foot and ankle, with spasmodic contraction of the toes.

Crampy pains in the lower limbs, worse on motion. Excessive drawing and contracting pains in gastroc nemius

muscle of the left leg. Coldness of the extremities, especially the feet, often severe. Rheumatic pain in the right knee, and left side of the neck. Paralytic symptoms throughout the entire muscular system.

Skin.

• Papulous eruption, resembling measles. Pimples on the forehead and neck.

° Measles (one of the best remedies, especially for the catarrhal symptoms).

° Erysipelas, not vesicular or phlegmonous, but a milder variety, with erythema or papular eruption.

Sleep.

• Disposition to sleep, a sort of stupor. Drowsiness and long, sound sleep.

Unusually sound morning sleep, with difficult, weary waking.

Languor and drowsiness when trying to study.

° Stupor attending the fevers of children.

° Sleeplessness during dentition.

0 Sleeplessness from nervous irritation.

Fever.

• Marked decrease in the frequency of the pulse.

• Chilliness, especially along the back, followed by heat.

• Febrile chilliness, cold extremities, heat of the head and face.

• As soon as the reaction takes place after the chill, the pulse

rises as much above the normal standard as it was

depressed below it. 0 Simple fever, without functional disturbance. ° Flushed, crimson face during the fever. 0 Remittent fever (infantile or malarial). ° Irritative fever, from abscesses, internal inflammation, etc. ° Intermittents (post typhoids).

° Fevers characterized by severe chill, little shaking, followed by fever.

° Fever without thirst; wants to lie still and rest; tonsils

inflamed, right side. ° Typhoid fever in the first stages. ° Scarlet fever, with stupor, and flushed, red face. ° Suppressed intermittents, with general prostration, aching

and soreness in the body; "dumb-ague." ° Intermittent fever; malarial, generally quotidian. ° Rheumatic fever (especially in muscular rheumatism). ° Intermittent fever (tertian type); pain in the head and pains

over the body, when he has no chill ; tongue not much

coated.

° Intermittent fever (tertian type); fever five hours, very hot, with delirium, jerking of the limbs, violent headache; aching in one leg.

0 Intermittent fever (tertian type); no chill; fever at 10 a. m. ; great pain in the back and thighs.

° Intermittent fever; chills from fifteen minutes to two hours long, followed by heat, often with sleep one to twelve hours long, and perspiration for some time.

° Fever coming on every evening after supper, which gradually increased, and went off before morning, the patient continuing asleep.

• Typhoid fever in a child of five years; nervous movements,

every night, like spasms; oscillation of the eyeballs.

• In scarlet fever it determines the eruption to the surface, controls the pulse, calms the nervous erethism, and lessens the cerebral congestion.

° In the forming and inflammatory stage of measles, with chilliness, watery discharge from the nose, etc.

"Rubeola; it seems to prevent chronic catarrhal affections, and bronchitis.

° In all eruptive fevers the Gelseminum may be thought of.

° Especially in the eruptive fevers of children when there is a strong tendency to convulsions at or about the time of the appearance of the eruption.

Nervous System.

Acute, sudden, darting pains, evidently along single nerve branches, in almost any part of the body and limbs, sometimes so sudden and acute as to make me start.

"Neuralgia; absence of organic lesion, with indistinct or double periodicity.

0 Hysterical epilepsy, after suppressed menses, lasting an hour or two; so severe was the spasm of the glottis that asphyxia seemed inevitable.

° Epilepsy of ten years' standing, preceded by dull feeling in the head and vertex, and some pain and fullness in the region of medulla oblongata; (marked improvement from the use of Gelseminum).

0 Tetanus; spasmodic action entirely ceased after the third dose.

Seems strongly indicated in hydrophobia, as it relaxes all the muscles, calms the fury of nervous excitement, relaxes the glottis, and prevents spasms.

° Laryngismus stridulus.

° Coma and apoplexy, sub-arachnoid, arising from passive

congestion, with nervous exhaustion. 0 Hysteria in a lady of 40.

r Cerebrospinal meningitis, ushered in by a severe chill, accompanied by evident congestion of the spine and brain, etc.

0 Nervous chills, in which, with shivering and chattering of the teeth, there is no sensation of chilliness.

Glandular System. increases it.

Muscular System.

• Intense prostration of the whole muscular system.

0 Myalgia from over-exertion, lameness and stiffness for sev eral days.

0 Acute myalgia, accompanied with fever.

Mucous System.

• Catarrhal condition of all the mucous membranes, acute,

with fever, or chronic when suppressed, and other disturbances appear.

Volume II — Special Therapeutics

The Yellow Jessamine is one of the most important and interesting of all the new remedies. Although it has been studied

with much interest by investigators of all schools, much remains to be discovered concerning its pathological and pathogenetic effects.

It possesses a peculiar interest to me, and I hope the class will be kind enough to listen to its medical history in the homoeopathic school.

After the appearance of the provings of Podophyllum, Sanguinaria, and Phytolacca, nearly twenty years ago, no new investigations of any importance appeared relating to our indigenous remedies. In 1860 I became interested in the brief notices of Gelseminum which I found in eclectic medical journals, especially the cases of poisoning, which were of unusual and unique character.

I therefore began, with Dr. J. S. Douglas, of Milwaukee, a series of experiments, physiological, pathogenetic, and clinical. The more I investigated its properties the more I became convinced that it would prove a valuable addition to our Materia Medica.

In 1862 I had collected enough data to enable me to write a monograph of fifty-six pages, octavo, which Dr. Lodge, of Detroit, was kind enough to publish.

Such was the interest excited by this brochure that the whole edition was disposed of in a very short time, and the remedy rose in the estimation of physicians, till it took a front rank along with Aconite and Belladonna in the armamentarium of homoeopathic practitioners.

The reception of Gelseminum was so favorable that it emboldened me to study and investigate other indigenous plants, and embody the results of such studies in a volume entitled “ New Remedies,” published by Dr. Lodge.

While I am proud of the title which some of my colleagues have given me of “ Father of the New Remedies/’ I must accord to Dr. Lodge the title of “ Godfather,” for he it was who took the risk of publishing the work and placing it in the hands of our school.

Ten years have now elapsed since the publication of the original monograph, and the literature of Gelseminum and of nearly all the new remedies has grown largely, and will still grow, I hope, during the next and succeeding decades.

The cases of poisoning on record, and those which I have observed in men and animals, show the following effects:

(1.) General prostration and paralysis of all the voluntary muscles, while the mind is clear and the involuntary motions are intact. In this stage, dimness of sight, slight or complete, is nearly always present, together with dropping of the eyelids, with much difficulty of opening them. A slight degree of stupor or sleepiness is usually present, or a sluggish condition of the mental faculties, which are, however, easily aroused.

(2.) Partial paralysis (complete if death occurred) of all the involuntary muscles. First the sphincter muscles, then the respiratory, and finally the heart. In this stage the functions of the brain are not always abolished, but can be aroused by electricity and physical agitation of the body. In other cases a profound stupor occurs, which lasts until death or convalescence.

(3.) In some exceptional cases, when a very large dose is taken, the brain seems suddenly congested, and a kind of apoplexy occurs.

In cases where death seemed imminent, or was to all appearances present, recovery has been brought about by the free use of stimulants and galvanism.

The nearest analogues of Gelseminum are Calabar bean and Conium; next in order come Aconite and Veratrum viride; and, finally, Chloral hydrate may have a close resemblance. It has been thought by some to stand midway between Aconite and Belladonna and the other narcotics ; but the fact is that its primary action and secondary effects follow each other in the same order as those first named, while they appear in reverse order when compared with those of Belladonna and its congeners. In other words, the primary effects of Gelseminum are similar to the secondary effects of Belladonna.

The sphere of action of Gelseminum is doubtless principally confined to the motor side of the spinal cord, the brain, and the mucous membranes. The sensory nerves are certainly not as profoundly affected by Gelseminum as by Aconite, for I have never seen it produce the benumbing sensations or the anaesthesia of the latter, nor does it cause primarily the hyperaesthesia of Nux,

although it may secondarily. I am of the opinion that it primarily causes passive congestion of the brain and spinal cord, just as Nux causes active congestion of those organs.

Gelseminum, like Calabar and' Conium, benumbs and paralyzes the nerves of motion, both voluntary and involuntary (primary), while Nux and Belladonna irritate and excite both sets of nerves. While Gelseminum produces death by a condition of general paralysis or passive apoplexy (primary*), Nux causes death by inducing just the opposite, namely, a tetanic state or active congestion of the cerebro-spinal centres (primary).

Nux and Belladonna cause, by their secondary action, a kind of secondary general paralysis similar to the primary effects of Gelseminum and Calabar.

I make these comparisons in order that you may study the symptoms of both understandingly.

It is almost impossible to separate the primary from the secondary symptoms, as the provings stand ; but it will greatly aid you to do so, if you understand the nature of the primary and secondary states caused by this drug.

I cannot undertake to give you information as to all the morbid conditions to which Gelseminum is homoeopathic, nor can I give you the symptomatic indications for the remedy in all cases. You must, by careful study and comparison, become familiar with its provings and pathogenesis, which you will find in my special “ Symptomatology of New Remedies,” and in all your textbooks on materia medica.

Bearing in mind my doctrine of dose, as relating to the primary and secondary action of drugs, you will readily understand that in diseased conditions which resemble the primary effects of Gelseminum, you should prescribe only the middle and high attenuations.

Among the disorders in which this medicine is primarily indicated are :

(1.) Paralysis, general and special, of the voluntary and involuntary nerves (of the striped and unstriped muscles). (2.) Passive congestions of the brain, spinal cord, lungs, liver, and other organs. It is secondarily indicated in

(1.) Convulsions , first of the voluntary, then of the involuntary muscles, namely : Hysteria, chorea, tetanus, puerperal spasms ; spasms of hollow organs — of sphincter muscles. (2.) Active congestions of the brain and spinal cord and other organs. (3.) Fevers and local inflammations, hyper cesthesia, neuralgia, etc.

The Gelseminum is an important /ever remedy, forming one of the group, Aconite, Baptisia, Veratrum viride, and Gelseminum. It is useful in all fevers where the symptoms indicating the drug are present, but it will be found most useful in the following orders :

(1.) Catarrhal fevers, from the influence of a cold, damp atmosphere, or a sudden change from hot and dry to damp air. When influenza is epidemic, at any season of the year, you will always find cases where this remedy is called for by the following symptoms: Chilliness up the back, cannot move away from the fire without chilliness; the head is hot before the fever sets in, which is not attended by thirst, restlessness, and anxiety, as with Aconite, but a torpid, heavy condition. The head feels heavy and big, the face scarlet, the eyes suffused, the nose runs a watery mucus, but little sore throat, the pulse large, full, and quick, but not very hard, and the febrile motions are remittent , aggravated about the same hour every day.

[Right here I will give you the characteristic pulse of each fever remedy : Aconite : Pulse small, hard, wiry, quick. Veratrum viride: Pulse hard, full, bounding, incompressible. Baptisia: Pulse quick, full, irregular, compressible. Gelseminum : As above given.]

(2.) Bilious remittent fevers, when caused by atmospheric changes in the spring, or due to miasmatic influences in the autumn. The febrile symptoms areas I have given them above, and, in addition, such symptoms as intense frontal or occipital headache, puffed face, slimy and bitter taste in the mouth ; the tongue may be coated white or yellow, and the breath is foul. In the fall these fevers often take the place of agues, and may change into that form ; but the Gelseminum is equally useful in

(3.) Intermittent fevers, miasmatic or not. It is best indicated in the quotidian type. I do not deny its power of curing tertians or quartans, as it seems to have done, judging from the reports of

various physicians ; but in an extensive practice of many years I have rarely found it useful in any but quotidians. It possesses the curious power of changing a quotidian, or bilious remittent, into a tertian fever. The special indications are chills along the hack ; fever with hot head, flushed face, cold feet, sleepiness, followed by hot perspiration, rarely thirst and vomiting. In most cases it should be given low, even a few drops of the tincture every two hours in bad cases, continued through the apyrexia and paroxysm. It prevents the convulsions in children with agues better than any other ague remedy. It is useful in so-called “dumb ague,” made so by Quinine. In such cases it follows Ipecac, with excellent effect. It is also indispensable in “ masked ague,” assuming strange forms, such as chorea, neuralgia, etc.

(4.) Infantile remittents, when due to irritation of teething, or intestinal troubles, or worms, or when caused by malarial influences. In such cases it acts better than any other fever remedy, but should be alternated with some remedy more homoeopathic to the special irritation.

(5.) Irritative fevers, or that type which is caused by some local irritation, such as ulceration, suppuration, the presence of a foreign body, etc. I know of no remedy which so readily controls this fever, while some specific remedy, or surgical treatment, removes the cause. In hectic fever, which is a variety of the above, even when shaking chills, followed by great heat and drenching sweats, occur, as in phthisis or pyaemia, the Gelseminum will arrest the paroxysms for a long time.

It may be useful in some cases of enteric or typhoid fever , but unless such fever commenced as a catarrhal I should not rely upon it. Even then it would be useful only in the first stage.

In cerebrospinal fevers it is especially useful, and ought never to be forgotten. If you refer to the head-symptoms and the cerebral conditions you will see the reason why. It causes both passive and active congestion, and inflammation of the meninges of the brain and cord, but of a less intense degree of severity than Veratrum viride or Belladonna. It occupies a position between the two. If any of the above fevers are attended by cerebrospinal irritation, it renders Gelseminum all the better indicated.

In all the eruptive fevers (the acute febrile exanthemata) it maybe indicated, but especially in measles, as it causes both the catarrhal symptoms and the papulous eruption.

In all it assists in determining the eruption to the surface and wards off the convulsions which tend to appear with the eruption. The mental indications are different from those of Aconite or Verat. vir. ; it has no anxiety with fear of death, but a torpor, a sleepiness and dread of movement, which is an unfailing indication.

In the South it has been found valuable in yellow fever, but I have had no experience with it in that terrible malady. From the records of the symptoms of that fever, I judge that it may be indicated in some cases.

You will find the Gelseminum an indispensable remedy in many diseases of the brain and head, which I will briefly enumerate:

In active congestion of the brain, when occurring during fevers, from unusual exertion, or from exposure to the sun. (Use the lowest dilutions.) In meningitis, especially in children ; in passive congestions. (Use here the middle dilutions.) In threatened or actual apoplexy, with stupor, coma, and nearly general paralysis. (It is rarely useful in hemiplegia or paraplegia.) In all these cerebral affections, stupor, torpor of the mental faculties, and wild, incoherent delirium is the rule ; while active excitement and violent delirium is the exception.

The headaches of Gelseminum are both intra- and extra-cranial. It corresponds to the congestive variety, the cerebrospinal, and the febrile. It is also curative in the neuralgic, especially when due to malarial or catarrhal influences.

The typical Gelseminum headache may come on suddenly, with dimness of sight or double vision; with vertigo, great heaviness of the head, it feels too big, and often too “light;” with a semistupor, bright red face; dull, heavy expression of countenance; full pulse, and general malaise ; or,

The headache may be of a settled, dull, heavy character, mainly in the occiput, mastoid, or upper cervical region, extending to the shoulders ; relieved when sitting by reclining the head high on a pillow.

In neuralgic headaches the pain is either in the upper cervical and occipital region, extending upward and forward, or it occupies the forehead, over one or both eyes. The pains are cramplike, drawing, tearing; aggravated by any exertion or study.

Gelseminum is the best indicated in these headaches when they are remittent or intermittent. A characteristic symptom is “ sensation as if a band was drawn tightly around the head above the the ears, with soreness in the scalp and brain.” The head may even be retracted backwards , and is relieved by bending the head forward. ( Contra in Calabar.)

Headaches of this character have been cured promptly, in the practice of many physicians, by the tincture and low dilutions. A few cases have been as promptly cured by the 200th potency.

In diseases of the eyes, Gelseminum ought to prove curative in many cases. I have myself used it with benefit in amaurosis, and it has cured many cases in the hands of other physicians. The disorder was generally attended by dilated pupils, a disturbance of the power of accommodation, a misty appearance before the eyes, and heaviness of the lids. This last symptom is a peculiar characteristic of the drug. A person under its pathogenetic influence finds the eyelids so heavy he can scarcely lift them. It may even cause complete paralysis of the lids — an indication of grave cerebral disease.

It causes dimness of sight invariably, and if enough is taken complete blindness results. The exact pathological condition upon which this blindness depends has not been fully determined.

When proving Gelseminum fifteen years ago, it caused an asthenopia, from which I have never fully recovered. It ought to be homoeopathic to that disorder, and ought to cure it when given in the very highest potencies.

It has caused hemiopia and diplopia. One of the most recent provings has this symptom : “ Everything seems like rolling water before the eyes.”

Dr. Woodyatt, of Chicago, and many oculists of our school in other cities, value it highly in some nervous and paralytic affections of the eyes.

In acute ophthalmia it does not appear to be generally useful, but in that curious form which occurs periodically, namely, an intense periodical congestion, from suppressed or masked ague, it cures promptly.

The ear-symptoms are not notable. It causes rushing and roaring, and sudden deafness, which may be due to catarrhal trouble, or paralysis of the auditory nerves, both of which it will cure. It is an excellent remedy for otalgia , when applied topically, a few drops on cotton introduced into the ear.

The catarrhal condition to which Gelseminum is homoeopathic affects all the mucous surfaces, especially those of the eyes, nose, and ears ; and in the severest colds, when they affect all those organs, and the whole head suffers, there is no better remedy.

It is rarely useful in chronic catarrh, while it is our best remedy for the effects of suppressed or undeveloped catarrh.

In affections of the mouth, tongue, and throat it presents a marked contrast to Aconite. The Gelseminum affects the nerves of motion more than the nerves of sensation, while Aconite acts in the opposite manner.

The primary effect of Gelseminum is to paralyze the muscles of the tongue, glottis, and the whole apparatus concerned in deglutition and vocal efforts ; but this paralysis is not attended by the numbness and tingling caused by Aconite. The secondary effects of the drug result in spasmodic and tetanic conditions of the same muscular structures.

You will be able to cure, as I have cured, some sudden and alarming paralytic affections of the throat with the high dilutions; while in spasm of the glottis, spasmodic croup, and laryngismus stridulus you will be successful with more material doses.

We can trace this same paralytic and spasmodic influence of the Gelseminum all through the body. In the stomach it causes a peculiar feeling of weakness and emptiness, which may be attended by that peculiar vomiting which is due to paralysis of the oesophagus. The sense of weight in the stomach, with dull pain, is indicative of the cramp which will result from its secondary action.

The abdominal symptoms of Gelseminum are due to two conditions : (a) a primary paralysis, and secondary spasm of the motor nerves ; (6) a catarrhal affection of the intestinal mucous membranes with sympathetic muscular irritation.

You will find it useful, then, in some singular paralytic conditions, especially of the sphincter. Many provers observed that it

caused an involuntary diarrhoea, or, rather, a tendency to involuntary evacuations from the bowels, excited by emotions of a depressing character, — as bad news of battles, disappointment, etc. Many cases are recorded where it cured similar conditions. During the war it was very effectual in the diarrhoea of soldiers, especially when aggravated by the excitements of the struggle. In these cases probably the catarrhal and nervous elements of the disorder were both present. A case has recently been reported of a “ chronic diarrhoea, aggravated by exciting emotions,” cured by one dose of Gelseminum 2000th !

It is indicated in acute catarrhal enteritis, which may take the form of mucous diarrhoea or mucous dysentery, according to the grade of the inflammation. In the first stage of this affection the discharges may be almost involuntary ; in the advanced stage they may be attended by intense spasmodic colic and tenesmus, both of which conditions equally indicate Gelseminum.

The evacuations may be bilious as well as mucous. This is due to a catarrhal irritation of the liver, but not to any specific influence exerted by Gelseminum on that gland.

It has been suggested by some as a possible palliative in intense pain caused by spasm of the gall-duct during passage of biliary calculi. It is worth a trial, if Chloral is not at hand.

The same paralytic and spasmodic conditions we have mentioned are found in its action on the genito-urinary apparatus. It has cured enuresis from paralysis of the sphincter ; u wetting the bed ” in children ; paralysis of the bladder in old people ; and involuntary micturition from exciting emotions. It has also cured opposite conditions, namely : dysuria, with frequent urging, scanty urine, and vesical tenesmus ; spasmodic retention of urine. It has no specific influence on the kidneys, but its primary effect is to cause the so-called “ nervous urine,” a profuse limpid flow from nervous excitement.

The primary effect of large doses of Gelseminum on the uterus, is to cause a paralysis of its motor power. This condition leads to those morbid states for which the remedy has been used so successfully in the high potencies, namely : atony resulting in want of contractility, false labor-pains, passive haemorrhage from loss of contractility. Secondarily, it causes congestion of the uterus ,

spasmodic pains, neuralgic pains associated with cramps in the uterus and legs. It will therefore cure those conditions when given in the lowest dilutions. I know of no remedy more efficient in most cases of dysmenorrhoea of the above character, violent after-pains, cramps in the uterine ligaments. (The pains of Gelseminum commence in front, and extend upward and backward to the sides and back, or down the limbs.)

Gelseminum has been found useful in irregular uterine contractions. Dr. Fountleroy says :

The following interesting and unique case is briefly submitted in further illustration of the therapeutic uses of Gelseminum. The writer was called in consultation by Dr. William H. Byerly. The following history was elicited: In the three previous confinements, from the irregular contractions, partially affecting the muscular fibres, without uniform hardening of the uterine globe, — from the exhaustive continuance for two or three days of the inefficient contractions, marked by frequent pulse, coated tongue and mental wanderings — the doctor had been forced to relieve his patient by a resort to instruments. When called upon the labor had commenced ; the os uteri was partially dilated, and not at all rigid, but the contractions evidently involved different planes of the uterine muscular tissue, first in one part, then in another. From his former experience the doctor anticipated trouble and delay. The writer suggested the use of Gelseminum, believing that the irregular uterine contractions were due to the want of tone in the sympathetic nervous system. Whether true or not, the result seemingly sustained the theory. Eight drops of the fluid extract were administered at an interval of two hours. After the second dose the uterine contractions became more general, and improvement gradually followed until after the eighth dose, when the patient was delivered, by the unaided forces of nature, of a large healthy child.

It has been used successfully by obstetricians in deficient laborpains, or when the pains are severe but make no progress owing to a rigid os uteri. In the former case the medium attenuations are useful, but in the latter quite large doses are often required (ten drops every half hour till relaxation). When your patient is threatened with convulsions during confinement, and the pulse is large and soft, the face puffed and the expression heavy, do not hesitate to give ten or fifteen drops every fifteen minutes, while you are hastening the labor by the forceps or other means.

Its action on the male genital organs is analogous. It causes impotence from lack of muscular power in the penis, while it does •not abolish sexual desire. It is thus homoeopathic to that form of emissions which occur at night from dreams, or by day from sexual

excitement, without erections. In such cases it will cure in the 30th and upward.

I do not think it will be found as useful in active nocturnal emissions, unless they occur from local irritation of the seminal vesicles, or during gonorrhoea with chordee. If useful here, the tincture is required.

I know of no remedy so generally useful in acute gonorrhoea, with great inflammation, scanty discharge, fever, etc. It controls the active symptoms, and often no other remedy has to be used ; it seemingly cuts short the disease. My usual efficient dose is two to four drops every two hours. When the discharge becomes thick, yellow, or creamy, Cannabis, Copaiva, Cubebs, or Oil of sandalwood are needed.

I should expect good effects from Gelseminum in spasmodic stricture of the urethra, for I have used it with benefit iu an analogous affection, — vaginismus, of a purely nervous character, with uterine irritation.

In these cases its internal use may be aided by an injection of the same.

I do not think Gelseminum is adapted to acute inflammations of the parenchyma of any of the organs of the body. Clinical experience has not found it of any value in pneumonia, pleuritis, carditis, or pericarditis, during the inflammatory stage. If useful at all, it is in the congestive stage. Its homoeopathicity to acute catarrhal affections makes it an excellent remedy in some disorders of the mucous membrane of the respiratory organs, when caused by cold and dampness.

It is all the better indicated in these catarrhal difficulties if motor disturbances occur, such as spasm of the larynx, pharynx, and glottis, or so-called spasmodic asthma.

The heart-symptoms of Gelseminum all point unmistakably toward cardiac paresis. The primary pulse of Gelseminum is soft, weak, or imperceptible, except during motion. The heart’s action becomes slow and very feeble, and the extremities become cold (but it does not cause the collapse of Aconite and Veratrum). One peculiar symptom of the heart is, “a feeling as if the heart would stop beating if she did not move about.” This was observed in a case of dangerous poisoning. It reminds one of the poisonous

effects of Conium, where life is prolonged by movement ; the symptom is just the opposite of Digitalis and China. I think it paralyzes the cardiac ganglia. In such cases movement of the body keeps the heart going by stimulating those motor nerves which are supplied to the heart from the spinal cord.

Dr. P. P. Wells, when proving Gelseminum, experienced a symptom which goes to prove this theory, “ A sensible motion of the heart as though it had attempted to beat, which it failed fully to accomplish, and the pulse then each time intermitted, worse when lying down in bed, especially when lying on left side.”

It is in cardiac neuroses that this remedy is best indicated. They may be primary, with deficient power and action, or secondary, with excessive action. In hysterical palpitation I have found it quite efficient.

Gelseminum is not useful in inflammatory rheumatism, only in that condition of catarrhal rheumatic pains before the catarrhal discharge appears, or when rheumatic pains appear after suppression of catarrh. In this respect it resembles Pulsatilla, Clematis, and Ranunculus, and should be studied and compared with them.

Future provings and experiments will doubtless increase the scope of the action of this drug, and give us new symptoms and special indications.

I predict that it may be found useful in some affections of the brain and spinal cord, in which it has not yet been used. It may be curative in locomotor ataxia, softening, and other serious lesions.