Veratrum viride

Volume I — Special Symptomatology

{American Hellebore?) Botanical Description. — Root perennial, thick, fleshy, its upper portion tunicated, its lower half solid, and sending forth a multitude of large whitish roots. Stem from three to five feet high, roundish, solid, pubescent, striated, closely invested with the sheathing hairs of the leaves. Lower leaves large, from six inches to a foot long, and half as wide, oval, acuminate, pubescent, strongly plaited, nerved, the lower parts of their edges meeting round the stem. Upper leaves gradually narrower; the uppermost or bracts, linear lanceolate; all alternate. Flowers numerous, green, in compound racemes, axillary from the upper leaves, terminal, the whole forming a sort of panicle. ***** A part of the flowers barren, so that the plant is strictly polygamous. Seed vessels of three capsules, united

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together, separating at top, opening on inner side. Seeds flat, winged, imbricated.

History. — This plant is indigenous to the United States, growing in swamps, low grounds and moist meadows, flowering in June and July. It is known by the common names of Indian poke and Itch weed. The officinal part is the root, which should be gathered in autumn, after the decay of the leaves. As it rapidly loses its virtues, it should be renewed annually, and kept in well-closed vessels. "When fresh, it has a very unpleasant odor ; when dried, it is nearly inodorous, and has a sweetish, bitter taste, succeeded by a persistent acridity. Its physical and therapeutical properties strongly resemble those of white hellebore, and contains Veratria, gallic acid, etc. — King.

Pharmaceutists assert that the Veratria obtained from Veratrum viride, and the alkaloid obtained from Veratrum album, are identical.

The root imparts its properties to alcohol, 835, L e., diluted with 165 parts water to 1,000.

There are three other species of Veratrum, indigenous to the United States, namely, the V. pariflorum and V. augustifolium (grass leaved veratrum). The latter is called by Gray "Stamantheum." These are probably medicinal and ought to be investigated. The third species, V. Woodii, or Indiana veratrum, found also in Illinois and Iowa; of this nothing is known concerning its medicinal powers.

Officinal Preparations. — Tincture of the root; dilutions.

Analogues. — Aconitum, Colchicum, Calabar, Gelseminum, Helleborus niger, Ammonium bromidum, Lobelia, Phytolacca, Tabacum, Tartarus emeticus, Veratrum album, Kali bromidum.

Mental Sphere.

Depression of spirits, but not always the intense anxiety and

fear of death as from Aconite. ° Cerebral congestion, causing insanity. 0 Puerperal mania. (See generative organs.)

Head.

• Headache, with vertigo : dimness of vision, and dilated pupils.

• Headache, preceding from the nape of the neck, with heaviness of the head. Sharp, drawing pains over the left eye; with a contracted feeling of the skin of the forehead.

• Dull, frontal headache, with neuralgic pains in the right

temple, close to the eye.

• Great pain, with fullness in the head; face much flushed;

burning in the head; spots before the eyes; delirium or a kind of stupefaction.

• Severe frontal headache, with vomiting.

c Active cerebral congestions y congestive headache in plethoric

persons from suppression of the menses. 0 Acute inflammatory meningitis.

° Fullness and heaviness of the head, with throbbing of carotids; booming in the ears; sensitiveness to noise.

° Cerebrospinal meningitis, when ushered in by high fever, great congestion, etc., or without fever, but cold, haggard face, slow pulse, etc.

Face and Nose.

• Pale cold face; bluish, and covered with cold perspiration.

• Convulsive twitching of the facial muscles; mouth drawn at

one corner. Nose looks pinched, cold and blue. ° Chorea; convulsive motions of the facial muscles.

Ears.

Kinging in the ears; moving quickly produces complete deafness.

The ears are cold and pale.

Eyes.

Profuse secretion of tears.

'* Dimness of vision, with dilated pupils.

Immense circles of a green color appeared around the candle, which as vertigo comes on, and I closed my eyes, turned to red.

• Double vision.

Sudden change of position, and washing brings on blindness

and faintness. ° Amaurosis from anaemia.

° Amaurosis from irritation or congestion of the optic nerves. Mouth, Fauces and (Esophagus.

Tongue feels as if it had been scalded.

• Tongue coated yellow along the centre, with flat, bitter taste

in the morning. Tongue yellow at the sides, (edges) and a red streak in the middle.

• Intense burning in the fauces and oesophagus, with constant

inclination to swallow.

• Spasms of the oesophagus, with or without rising of frothy,

bloody mucus into the mouth. ° Sensation as of a ball rising in the oesophagus. ° Oesophagitis (in one case where the inflammation was located

at the cardiac orifice, prompt relief was obtained by Veratrum viride). {Hale.)

Appetite.

Increase of appetite, and digestion (from small doses).

Stomach.

• Excruciating pain in the lower part of the stomach.

• Constrictive pain, increased by warm drinks.

• Violent nausea and vomiting, with collapse; very slow

pulse, and cold sweat.

• Painful, empty retching, with ejection of only a little bloody

mucus.

Severe hiccough, with sensation of dryness and heat in the throat.

Violent vomiting, coming on every fifteen minutes.

• Smallest quantity of food or drink is immediately rejected. Pains in the stomach are drawing, twisting, pressing, aggravated by the least noise.

Stomach seems to press against the spine while lying upon the back.

Vomiting of bile and blood.

Sharp, flying pains in the epigastrium and umbilical region, pressing down to pelvis.

• Gastritis, acute — (here the high dilutions are useful).

° Neuralgic or spasmodic affections of the stomach, accompanied by vomiting, retching and excessive irritation. Abdomen and Stool.

• Neuralgic like pains at the right side of the umbilicus, passing down to the groin. Dull, heavy aching pains in the umbilical region. K Cutting, aching pains in the umbilical region, with rumbling

in the bowels, and desire for stool. Soft, mushy stool, preceded by cutting pains in the bowels,

and followed by cutting pains in rectum and anus. Neuralgic and long-lasting pains in the rectum.

Neuralgic pains in the left groin.

Haemorrhoids, half the tumor red and the other half purple. * Cholera and cholera morbus.

0 Acute enteritis with high fever, dark and bloody stools.

Kidneys, Urine, etc. Profuse urine, which is pale. Specific gravity is decreased. Increases the solid constituents of the urine. It is said to eliminate lithic acid. 0 Cystitis acutus, with fever.

Generative Organs. Male: ° Orchitis (acute), the local application is especially useful.

Female: ° Acute metritis. (Internally give the l-10th and apply a lotion externally.)

0 Congestions during uterine disorders— (reflex congestions to chest and brain).

° Menstrual colic (previous to the discharge, when the congestion is great).

0 Puerperal fever (with bounding hard pulse; cerebral congestion; delirium, etc.)

0 Convulsions before, during and after labor; (Hale, Ludlam, and many other authorities of all schools.)

° Vomiting during pregnancy. (?)

° Hysterical convulsions.

0 Congestive dysmenorrhea in plethoric subjects.

0 Puerperal mania; she becomes silent, suspicious and distrustful; would not see her physician; his presence seemed to terrify her; she feared he would poison her; complete sleeplessness, could be with difficulty confined to her bedroom (cured in six hours).

Chest.

• Active congestion and engorgement of the lungs.

• Anxious oppression of the chest.

• Sensation as of a heavy load on the chest.

• Constant, dull, burning pain in the region of the heart. Oppression of the chest with nausea.

° Pneumonia, with high fever, will arrest the inflammation

in the first stage. {Hale.) ° Pleurisy in the first stage; often superior to Aconite. Respirations fall from 18 to 12 in the healthy. Respirations fall from 40 to 12 in pneumonia.

Heart.

Prickling pains in the region of the heart.

Dull, aching pains in the region of the heart.

Constant burning distress in the cardiac region.

° Faintness after rising from the recumbent position.

Syncope when walking, only relieved by lying down.

Pulsations reduced from 68 to 24 in health; and from 140 to

33 in fever. Beats of the heart low and feeble, (p.) Palpitation of the heart, (s.)

Fluttering sensation in the region of the heart. («.) Palpitation on taking the least exercise, (s.) Strong, loud beating of the heart, with quick pulse, (s.) ° Palpitation, with dyspncea.

° Cardiac oppression, with passive congestion, and tendency to fainting and collapse [from the 3 x to the 6 x dilutions].

° Carditis and pericarditis, especially rheumatic, with strong forcible impulse, during the first stage [from the 1st to the 3d dilutions]. (Hale.)

Back.

• Very severe, and constant aching pains in the back of the

neck and shoulders. Neuralgic pains in the back.

° Cerebro-spinal congestion and cerebro-spinal meningitis. Extremities.

Drawing pains in the right elbow and calves of the legs.

• Cramps of the legs and of the fingers and toes.

• Galvanic-like shocks in the limbs, of great violence. Coldness, blueness and dampness of the hands, feet and limbs,

with cramps of extremities. Paralysis of the lower limbs.

Sleep.

Some sleep every night, but has frightful dreams of being on the water.

Restless nights, and frightful dreams of being drowned.

Fever.

Chilliness with nausea.

• Coldness of the whole body with cold perspiration on hands,

feet and face.

• Coldness, with pale skin, flabby muscles, and quick, weak

pulse.

° Pulse reduced from 130 to 60 in fever.

Pulse 35, slow and soft, with nausea and vomiting.

"Weak, scarcely perceptible pulse, reduced from 68 to 52.

Feeble, irregular, scarcely perceptible pulse.

° Ephemeral fevers, with vertigo, headache, dimness of sight,

nausea and weakness. ° Remittent or bilious fevers, not dependent on miasmatic

influences.

c Typhoid fever, commencing with violent arterial action; pulse 120 hard; violent pain in the back of the head; delirium and black diarrhoea. (Dr. Henry.)

° Typhus fever. (?) Fevers, with tongue yellow on the edges, and red in the centre.

0 All fevers with full, frequent, hard pulse, and tendency to congestion of the head, spasms, etc. (Hale.)

0 Yellow fever [was successfully used in Savannah].

° In certain typhoidal cases which the morbid action has continued for weeks, pulse at 130, under the use of Veratrum viride, the pulse sinks to 70 or 80, and rapid convalescence sets in.

0 Cerebro-spinal fever [" spotted fever in the first stage. (Ib.\ Generalities.

0 Acute rheumatism with high fever, full, hard, rapid pulse.

some pains in joints and muscles; very scanty red urine

— use the lowest dilutions. (Hale.) Sensation of prickling and tickling, particularly in the extrem

ities.

0 Violent pains attending the inflammations.

• Contortions of the muscles of the face, neck, fingers and toes;

head drawn to one side; mouth drawn down at one corner, and the facial muscles affected with convulsive twitching; at turns these contortions would take the form of tonic spasms, while at other times the action would simulate a series of galvanic shocks, frequently of such violence as to precipitate the patient out of bed.

° Exerts a sedative influence over the nerves of motion.

° Hysterical, epileptiform and puerperal convulsions and convulsions of children.

Complete loss of power of the locomotive muscles.

° Trismus, opisthotonos and other convulsions.

° Convulsion coming on suddenly, frothing at the mouth and violent jactitations of all voluntary muscles.

0 Chorea of two months' duration.

0 Chorea in a girl aged 12, the muscular commotion was violent, universal and unaffected by sleep; the lips covered with foam, worked up by a continued champing of the teeth; had not taken nourishment for days — [cured in four days].

0 Chorea, in a woman, childless, and subject to menorrhagia, with continual nodding of the head and violent convulsive action in one arm, and jactitation of one leg.

0 Chorea of two months' duration; the entire muscular system was in a continuous and tumultuous motion, the face was worked into the most horrible and ludicrous contortions; head constantly jerking; writhing of the whole body, and no sleep.

° Chorea, in a lady of thirty, constant moving of the head, lower jaw, larynx and tongue, twitching of the head, jerking of the arms and lower extremities; when these symptoms would subside, she would be attacked with violent palpitation of the heart. Yeratrum always relieved this cardiac chorea.

0 Puerperal convulsions, with furious delirium, found curative in doses from ten to thirty drops every hour till the convulsions subsided.

0 Cerebro-spinal disease; pulse quick and wiry; pupils dilated; muscles of the back and neck contracted, drawing head back on the shoulders; delirium; spasmodic cough; finally tetanic convulsions occurring every five or ten minutes for

five days; opisthotonus; cold, clammy sweat over the body. Yeratrum brought about a rapid recovery. ° Cerebro-spinal disease in a child; burning fever, frequent vomiting, cries out on any attempt to move him, draws the head backwards, rolls up the eyes, puts the hands back of his ears, rolls the head from side to side, pulse wiry, rapid, 150, spinal column pungently hot and dry with peteehice; cured in five days. (2.) A child of three months, very much emaciated, head much enlarged and misshapen, drawn back, so much contraction of the spinal muscles is compelled to lie on side, eyes rolled upwards, rolling of the head, moaning and screaming, great heat in back of the head and spine, respiration feeble and sighing, pulse 160 and feeble, watery diarrhoea, urine scanty and high colored; all these alarming symptoms disappeared in a week.

0 Epileptiform convulsions in a boy of four and a half, with high fever, pulse 190, rapid respirations, 76 in a minute, and much cerebro-spinal irritation.

Skin.

Coldness of the skin, which is usually perspiring. Tingling and prickling of the skin. Cold, clammy and insensible skin.

Vesication of the skin when applied externally, also erythema. Hot, burning and sensitive skin. ° Eruptions of the skin, with very high fever. ° The first, or inflammatory stage of scarlatina, small-pox, measles.

° In scarlatina it wards off cerebrospinal irritation. ° Erysipelas; phlegmonous or vesicular; apply topically a lotion 3 i to § iv, and internally 1st x dilution.

Volume II — Special Therapeutics

This indigenous species has attained great popularity in all schools of medicine, not only in this country but in all others where medicine is progressive.

It is a little singular that the two species, the viride and album, although said by chemists to possess similar constituent principles, should be used in almost diverse conditions. Homoeopath ists, who use both very extensively, never use the album for fever, and rarely, if ever, the viride for choleraic symptoms or collapse.

This shows conclusively how valueless the results of chemical

analyses are when we wish to know the exact powers of drugs; and that a thorough series of experiments only can give us exact knowledge of their curative power.

The medical history of this plant may be of interest.

Dr. Osgood states that this plant was known to the aborigines as a poison rather than a medicine, and he adds, on the authority of Joslin, that, it was made use of by them in the election of their chiefs, the individual whose stomach was the least susceptible to its deleterious influences being regarded “as the strongest of the party, and entitled to command the rest.” It was also popularly used by the farmers of New England to catch and destroy the birds that ravaged their cornfields. It had long been employed by the late Dr. Tully, and other New England physicians, as a medicine, when attention was, for a time, particularly attracted toward it, in 1835, by an essay of Dr. Osgood. It was, however, but seldom prescribed until the appearance of a paper by Dr. W. C. Norwood, of South Carolina, in 1850. For a time it was extensively used and abused by the allopathists and eclectics. The first homoeopathic physician to call attention to this medicine was Dr. Henry, in 1852, who mentioned its use in cases of typhoid fever. Soon after this it was used by Dr. Pope, of Washington city, Dr. Jackson, of Boston, and a few others. I commenced its use in fevers, particularly in pneumonia, in 1855, and it has been a standard remedy in my practice ever since.

In 1863 the writer had some correspondence with Dr. Burt, and then suggested that he make thorough provings of the Veratrum viride. In 1864 Dr. Burt made an experiment with massive doses. It is one of the most heroic provings in our literature. Had we extended provings of the drug, made with the attenuations, our knowledge of its remedial powers would be greatly increased. No other provings, however, of any value have appeared.

Its poisonous action on animals has been very fully studied by Drs. H. C. Wood, S. R. Percy, Peugnet, Simon, Oulmot, Adams, and Burt.

I shall allude to these experiments when treating of its general action.

On Men. — In its local action, Veratrum viride is an active irritant. Its powder snuffed into the nostrils excites long-continued

and violent sneezing; applied to the skin, in a moist state, it produces redness and burning. Osgood found that two grains of the powder caused him to vomit, and observed that the act was at first unattended by nausea, and seemed to be performed by the contraction of the stomach and oesophagus alone. But in another person, who also presented this peculiarity, emesis was subsequently persistent and violent, and attended with bilious dejections. Norwood says that it is one of the most certain and powerful emetics, but may produce extreme nausea, as well as vomiting, which is sometimes continuous. Robert, a French physician, says that the pulse may be reduced by the drug as low as thirty-five beats per minute without nausea or vomiting! Osgood, Norwood, Raynor, and others assert that it does not cause catharsis , while Pendleton, Platt, and others quoted by Stille, assert it to cause “ copious watery evacuations 'per anum .” The same authorities have known it to cause the following conditions:

Faintness, somnolency, coma, dimness of sight, dilatation of the pupils, vertigo, headache, rarely delirium, impaired muscular action, general numbness, slow and infrequent respiration, hiccough ; a pale, cold skin, covered with clammy sweat, persistent vomiting, excruciating pain in the praecordia ; profuse, watery diarrhoea in some cases, and a small, infrequent, and generally feeble pulse. Alarming and apparently dangerous as these symptoms are, it does not appear that they have terminated in death ; on the contrary, they have generally been dispelled by administering diffusible stimulants.

The action of American Hellebore strongly reminds us of the “Helleborism of the Ancients,” so graphically described by Hahnemann. It is said that very few persons died from the apparently dangerous effects of Veratrum album.

This case was reported by Dr. W. H. Woodbury:

Prescribed for a gentleman about forty -five years of age, as an expectorant, forty drops of the tincture of Y eratrum viride in an ounce of water, and directed a teaspoonful of the mixture to be taken every three hours. The first dose was taken as directed, the patient waited an hour, and not perceiving any particular action from the medicine concluded that the dose which I advised was much too small to affect him, and that it would be perfectly safe to take any quantity of the medicine, or even take the whole contents of my pocket-case at one dose. He took a tablespoonful of the preparation, in all twenty drops of the tincture. From ten to fifteen minutes after taking the enormous dose he experienced a burning sensation in the throat, oesophagus, and stomach, dizziness and pain in

the head, with dimness of vision, dilatation of the pupil of the eye, severe nausea, but very little vomiting. I was called about half an hour after the last dose had been taken. Found the patient in great distress, very pale, with a cadaverous look ; convulsive breathing, almost to suffocation ; pulse very small, about forty per minute ; extremities cold, to the elbows and knees ; a profuse cold perspiration over the hands and face ; weakness and stiffness of the limbs, with frequent efforts to vomit, and extreme prostration. I ordered an application of mustard and vinegar to the chest, and prescribed Ipecac., which produced full emesis of mucous and bilious substances, vomiting profusely five or six times, after which I prescribed Camphor and whiskey, a teaspoonful every ten minutes at first, and continued as the case required. Narcotic symptoms were now more manifest ; the patient became somnolent, soon followed by lethargy, which continued four hours, from which he awoke feeling much better, though very weak, and complained of an indescribable sensation, more manifest in the limbs than elsewhere. I advised exercise in the fresh air, which he took by the aid of an assistant, which produced beneficial results, and the following day he was able to attend to his usual business.

Dr. G. N. Edwards, Assistant Physician to St. Bartholomew’s Hospital, reports the following case :

On Thursday evening, December 18th, I was summoned to see a gentleman, a scientific chemist, who had taken, experimentally, one drachm of Tincture of green hellebore (equal to about twelve grains of the powder). On my arrival I found him sitting in the water-closet, vomiting into the pan. His features were sunken; skin cold, and covered with a profuse clammy sweat; his pulse quite imperceptible. He complained of intense pain about the epigastrium. The vomited matter appeared to consist at first of the food and contents of the stomach, afterwards of glairy mucus. I gave him immediately about an ounce and a half of pure brandy, which at once checked the vomiting. At this time I was joined by Mr. Buxton Shillitoe, the patient’s usual medical attendant. As he had slightly rallied, we had him removed into a room a few yards from the water closet, and laid on a couch in front of the fire. The surface of the body was still very cold, especially the extremities. The clammy sweat continued, but the pulse could be felt indistinctly, beating very feebly and irregular, forty-four in the minute. A dose, containing Sp. sether. sulph. co. one-half dr., and Sp. ammon. arom. one dr., was given, but immediately rejected by the stomach ; but some brandy, given directly afterwards, was retained. A large mustard poultice was applied to the epigastrium, and a hot-water bottle to the feet. Two or three efforts at retching afterwards took place, and he once or twice vomited food, mucus, and a small quantity of blood. Warmth gradually returned to the surface, and the pulse became somewhat better in volume and power. Brandy was given at short intervals, and after about an hour a second dose of Ether and Ammonia, which was retained. The patient then fell asleep, slept for about a quarter of an hour, and awoke with the expression, “I am all right now,” and appeared comparatively well. There was no diarrhoea throughout. He had two or three times a slight return of the symptoms ; did not sleep during the

night, but was quite easy ; and the next morning only felt the discomfort arising from the mustard poultice, and the soreness of the muscles caused by the retching. He then gave us the following account of his feelings during the attack :

Before taking the dose of the tincture I had consulted Pereira, and finding Dr. Meade’s dose of the Tincture helleborus niger to be two teaspoonfuls twice a day, and knowing the green Hellebore to be of the same tribe, I considered, in taking one teaspoonful, I was rather under than overdoing it. The drachm of the tincture was taken about half-past 4 'or a quarter to 5 o’clock p.m., and my stomach soon afterwards whispered that 1 had admitted a troublesome guest. I went upstairs and sat down, thinking a cup of tea would set all right; but the uneasy constriction of the stomach continuing, with a tendency to sickness, made me retire to the water-closet. The sickness, once commencing, soon became alarmingly violent, with the most excruciating pain in the lower part of the stomach, the pain extending to about the size of my hand. The feeling at the seat of the pain was, that all the warm tea, water, etc, that I took to provoke the vomiting, went under the pain, making the constriction more and more violent. Finding the case getting desperate, I sent off for medical aid. The pain continued to increase, and the ejection of the stomach was now glairy mucus with blood, with running from the nose and eyes. The most painful and profuse cold sweating now came on, and the difficulty of breathing became more and more labored. I could not help wondering at the presence of anything like heat or constriction of the throat ; my mind was perfectly calm, and although I thought it more than probable that I should die, I did not feel alarmed. Hearing and recognizing the voice of one of my medical friends is all I recollected for some time afterwards. Immense circles of green color appeared round the candle, which, as vertigo came on and I closed my eyes, turned to red. The pain continued excruciating at the pit of the stomach, and a slight tendency to cramp existed when my legs were touched. It was some hour or more afterwards when I awoke and found myself comparatively well. The sting of the mustard I can well recollect, and the horror of being forced to swallow brandy is even now with me. My bowels were not at all acted on.

A case of poisoning is reported by Dr. W. H. Burt:

My little girl, aged twenty-one months, got hold of my pocket-case, and I found her sitting down eating medicine. She had a bottle of Veratrum viride in her hand, with the cork out, and its contents emptied. It contained one-eighth of a drachm of the tincture. She could not have had the case more than five minutes before I discovered her, but in about two minutes she commenced vomiting. I immediately gave half a cup of coffee, and then went for some Camphor ; returned in about five minutes. Her jaws were then rigid and nothing could be put in her mouth ; pupils of the eyes widely dilated ; face blue ; hands and feet cold ; no pulse could be found at the wrist. Bathed her bowels and back with Camphor for a few moments, when she went into a spasm, with violent shrieks ; body bent backwards ; arms rigid and thrown over her head ; face dark blue; breathing suspended for several seconds ; lasted about two minutes ;

remained easier for a few moments, and then went into another spasm similar to the first. I then placed her in a tub of warm water, which soon relaxed the whole muscular system ; vomiting kept up, with severe retching every few minutes for three hours, when it gradually subsided. The matter vomited was a white, ropy mucus. The interval between vomiting for three hours was not at any time longer than five minutes, and most of the time did not exceed one minute. She remained pulseless all the time, with a blue, hippocratic face; hands and feet shrivelled up, as if they had been in water for a long time. When she was not vomiting she lay in a stupor ; pupils of the eyes widely dilated. After three hours the pulse could be counted ; it was thirty-six ; very feeble.

In three hours and a quarter after taking the Veratrum she went to sleep, and slept quietly and soundly for three hours, and then awoke well, except being a little weak.

The leading symptoms in this case were : Constant vomiting of a white, ropy fluid ; dilatation of the pupils ; comatose state of the brain ; great congestion of blood to the lungs ; blue, pinched up, hippocratic face, with cold nose, hands, and feet ; spasms ; trismus ; no pulse for three hours ; pulse 36, very weak and soft.

I would call especial attention to the spasms, and the effect it had on the brain and lungs. When I proved the Veratrum viride, one of the leading symptoms was, constant aching pains in the back of the neck and shoulders, so that it was almost impossible to hold the head up. I believe the Veratrum viride has a special affinity for the cervical portion of the spinal cord and base of the brain, but especially the spinal cord. The spasms my little girl had were in her thorax and back (Opisthotonos). The amount of medicine taken must have been small, probably only a few drops ; the whole amount of medicine in the vial would have poisoned her fatally in a short time.

In Jones and Scudder’s “Materia Medica” is the following case of poisoning :

Mr. Worthington took one-quarter of a grain of the alcoholic extract. It caused an acrid, burning sensation in the mouth, and communicated to the throat and fauces a sense of dryness and heat, which finally reached the stomach. In the course of an hour this dryness and burning sensation in the throat and stomach became intense, and a disposition to hiccough was excited, which soon commenced, gradually increasing in frequency until it reached fifteen or twenty times in the minute. This was attended with some sickness and retching, until vomiting took place. This was violent and seemed to come on about every ten or fifteen minutes for the space of an hour. During this time dizziness and tremor were created, which passed off with the dose. With the hiccough there was a copious secretion of saliva and discharge of mucus from the stomach and nose. During the action of this dose the pulse was weakened so as to be scarcely perceptible, and reduced from 68 to 52 pulsations per minute.

We have observed, says Dr. Scudder, similar symptoms, only more severe, in a case where half a fluid drachm of the tincture was taken by mistake instead of

Tincture of gelseminum. In this case the pulse was reduced from about 100 to 40 beats a minute. The prostration was extreme, and there was such great irritability of the stomach that it seemed for awhile that he must die from the impossibility of retaining the necessary stimulus. The fever did not return, though for some days the patient was much prostrated, the irritation of the stomach continuing for some time.

Another case of accidental poisoning has been reported to me :

The patient, a man aged thirty, was under treatment for pneumonia. By mistake seven or eight drops were taken every hour for four hours. About ten minutes after the last dose, great uneasiness appeared, followed in a few moments by intense pain in the stomach. This pain was of a drawing, twisting, passive character. The stomach felt as if drawn tightly against the spinal column, causing pain in the back in the dorsal region. There was at the same time drawing pain in the cervical region of the spine. The patient could not lie on the back, as it seemed to increase the pressure of the stomach upon the spine. This uneasiness and pain would culminate every five or ten minutes in a sudden, powerful, and expulsive vomiting, after which there would be a lull of a few moments in the pain. During the intensity of the pain there was great nervous sensitiveness. The least noise, as talking, walking across the floor, etc., would aggravate the pain intensely. The vomiting was not preceded by nausea, and was of mucus only. When the stomach had been emptied, there was excessive, painful, and ineffectual retching. The pain, vomiting, etc., reached its height in about one hour after the first onset, and subsided in about the same time, under the influence of Morphia. The fever, cough, and stricture of the chest seemed ameliorated after the effects of the Veratrum had subsided.

The above cases illustrate its toxical effects, and are at the same time partial provings.

We will now proceed to consider the general physiological action of Veratrum.

While accepting the results of the chemical analysis as undoubted, namely, that the alkaloid Veratria* is found in both Veratrum album and Veratrum viride , I deny that their pathogenetic and curative action is identical. They are similar in some of their effects, and that is all. If you study the pathogenesis of the two species, side by side, you can readily point out the symptoms which are caused by the alkaloids and those which are caused by

• Veratrum viride is said to contain two alkaloids, Veratroida and Virida, and an inert (?) resin. The most ancient analysis of Veratrum album proves it to contain the same alkaloids, with an active resin, “ very poisonous.” This resin makes the Veratrum album the more powerful of the two.

other unknown constituents. I once wrote down, for my own satisfaction, the differential diagnosis of the two medicines, which I may present some other time. It is not as complete as Farrington’s comparisons, but may be an aid to their selection.

Veratrum is primarily a cerebrospinal and cardiac- depressant. It causes a profound paresis of the whole circulatory apparatus, and its ultimate primary effect is to cause an equally profound paralysis of the cerebro-spinal and reflex-motor nerve-centres.

The action of Veratrum viride can be stated in a few words, as follows :

1. It acts on the heart in a manner the reverse of Digitalis.

[It is a direct and primary poison to the cardiac ganglia and the heart-muscle. The heart after death is relaxed and full of coagulated blood.]

1. Its action on the spinal cord is just the reverse of Strychnia.

[It primarily paralyzes the spinal cord and the reflex-motor

nerve-centres.]

Burt says: “Veratrum viride, by affecting the pneumogastric nerve {vagus), and by paralyzing its functions, produces congestion and inflammation in every organ and tissue to which it is distributed.”

I deny that Veratrum viride causes inflammation by its primary effect. The only inflammation (primarily) caused by the drug, arises from its local irritating effect on the skin and mucous membranes of the oesophagus and stomach.

It is by its secondary effects that Veratrum causes the peculiar congestion and inflammation to which it is homoeopathic. The congestion is an intense capillary hypersemia. The inflammation is the result of pressure in and rupture of the capillaries, and is as much mechanical as dynamic. It is quite unlike the inflammation of Belladonna, Tartar emetic, Phosphorus, or Sanguinaria.

The first experiments of Wood and others shed some light on its action :

The rapidity of the pulse and the arterial pressure were at first decidedly lessened. After a time, the pulse still remaining very slow, the individual heartbeats became endowed with four times their pristine force, and the arterial pressure became normal ; then, suddenly, the pulse-rate quintupled itself, the individual cardiac beats losing much of their extraordinary vigor, but the arterial pressure rising nearly fifty per cent.

He explains this as due “ to the asphyxia produced by the spinal action of the drug.” I dissent from this view, and look upon this increase of the arterial pressure as a secondary effect of the drug; and during this secondary effect we get the active congestion and first stage of inflammation.

The recent experiments of Dr. II. C. Wood, published in the “ Philadelphia Medical Times,” throw more light on the action of Veratrum upon the heart and circulation than any previous investigations, and verify my opinion.

These experiments proved conclusively that the primary slowing and weakening of the heart’s action was due to stimulation of the par vagum at its origin. This action on the inhibitory cardiac nerves differs from that of Aconite, which is believed to act on the peripheral cardiac branches.

Both act alike on the heart when out of the body, paralyzing it in diastole; but in the body the Veratrum paralyzes the heart by acting from the centre to the periphery through the pneumogastric; Aconite from the periphery to the centre.

The experiments made by Wood to decide the question whether the violent rise in the blood-pressure was due to asphyxia, resulted in proving that such was not the cause, but to a paralysis of the par vagum.

When the pneumogastric was cut, and Veratrum afterwards given, no slowing or weakening of the heart occurred.

When the Veratrum had been given, and the heart’s action was growing slower and weaker, and the cardiometer recording a rapid decrease in blood-pressure, section of the pneumogastric immediately caused the heart’s action to become quick and strong, and the pressure to increase rapidly.

This secondary action of Veratrum, after its primary depressing action on the heart, is due to paralysis of the pneumogastric.

Now this appears to me to be one of the most important discoveries ever made relating to the action of this drug. It is also important in its relations to the homoeopath icity of Veratrum to fever.

If this secondary action did not occur, Veratrum would be antipathic to fever, and our claim for the universality of the homoeopathic law would have to be abandoned.

That it is not a mere “reaction of the organism” is proved by the statement of Wood, based upon many experiments, that “ an excess of poison changed a condition of inhibitory excitation into one of inhibitory paralysis ; or, in other words, whilst a small dose of Veratrum excites , a large one paralyzes the pneumogastrics .”

This I have always believed to be the fact. I believe that all drugs capable of causing secondary symptoms have a similar modus operandi, and that in no case is there such a thing as a “ simple reaction of the vital principle against the drug,” but that primary and secondary action are both positive medicinal effects.

Burt and others are singularly oblivious of this secondary action when treating of Veratrum. To say that “congestion and inflammation is caused by Veratrum acting upon the pneumogastrics, in depressing their functions,” is only stating half the truth. Moreover, it is doing injustice to the physicians of our school, for, at present, only a small portion accept the doctrine of primary and secondary action, and the law of dose based thereon.

Consequently, acting upon the bald, unqualified assertion that Veratrum causes inflammation of the brain, lungs, liver, and spinal meninges, they use the dose ordinarily used by them in practice. If this dose is below the 2X it will cure ; if above (and nearly all would naturally use it above) no certain curative results are obtained, and the medicine is blamed as useless or inert.

During the primary effects of Veratrum no such conditions as above named could obtain. Congestion and inflammation cannot occur during a period of lowered blood-pressure; the only condition of the circulation then notable is that of venous stasis or passive engorgement.

We have no medicines whose primary action resembles the secondary of Aconite, Gelseminum, and Veratrum, unless it be Quinine. Therefore, we have no primarily indicated remedies for general sthenic fever, resulting in acute inflammation.

There are remedies which cause local inflammation, with resulting fever, as Cantharis, Belladonna, Mercury, Phosphorus, or Tartar emetic, but they are not indicated in idiopathic fevers.

Physiologically and pathologically, Quinine is primarily homoeopathic to a general febrile state, with inflammation in every

organ and tissue of the body ; yet it is never used by our school for such conditions. It acts on the brain and spinal cord in a manner very similar to Veratrum viride, only in a reverse order, i. e., its primary toxic effects are like the secondary effects of Veratrum.

If any other proof is wanting of this secondary action, it will be found in the clinical results of the use of Veratrum viride, namely, that minute doses do not have any curative action over congestion or inflammation of an active, sthenic type.

In the lung-tissue examined by Professor Charles Adams, taken from animals poisoned by Veratrum viride, “the microscope revealed intense congestion and a large number of the capillary vessels ruptured.” Burt says : “ Sections of the lung were so completely hepatized, that when thrown into water they immediately sank to the bottom,” and “ the smallest air-cells were completely filled with mucus.”

How, no such congestion and inflammation could occur during the period of decreased arterial pressure (primary), consequently it must occur during the secondary action, described in Wood’s experiments.

As I shall inform you, when treating of the use of Veratrum in pneumonia, it has been found that if large doses are given after the congestive stage, the latter stages are 'prolonged. This goes to prove that it is not secondarily homoeopathic to any but the first stage. Why ? Because, during the stage of red and gray hepatization, softening, and suppuration, the condition of the heart simulates the primary action of Veratrum. It is now known that death from pneumonia results ultimately from heartfailure.

What shall we deduce from these facts ? This : that Veratrum, if used at all during the later stages of pneumonia or any inflammation, must be used in minute doses. I am not sure, however, that it should be used at all in such conditions. There is no clinical proof of its value there. Remedies which are secondarily homoeopathic to cardiac debility must be chosen, namely, Phosphorus, Digitalis, or China (Quinine), aided by wine, beef tea, milk, and other nutritious substances.

Its primary action on the brain is to cause venous stagnation,

with lessened arterial pressure. It depresses the functions of the cerebellum, giving rise to abnormal movements, jactitations, clonic spasms, etc.

Its secondary action is intense arterial congestion. Dr. Adams’s microscopical examination showed “intense capillary congestion of both the white fibrous structure and gray cineritious substance, there being more congestion of the cerebellum than the cerebrum.” A clot was found at the origin of the pneumogastric, and effusion along its course. He also found great capillary congestion of the pons varolii.

According to Nothnagel, the “convulsive centre” is “located on the floor of the fourth ventricle, in the pons varolii.” This illustrates why Veratrum viride, is so useful in convulsions of a congestive nature, and why it is only useful in material doses, i. e., in the dilutions below the 2* and in small doses of the mother tincture.

H. C. Wood, in discussing this subject,* says :

On account of the violence of the convulsions, it has been asserted that Viridia is a spinal excitant. The convulsions are, however, really of brain, and not of spinal origin, as they do not follow poisoning by Veratrum viride when the cord had been previously cut.

No record of the pathological appearances in the cord or its membranes, in cases of poisoning by Veratrum, are on record, so far as I know. It is highly probable that it causes the same condition in the cord and meninges that it causes in the brain and its meninges.

Clinical proof is also afforded in the case of Strychnia poisoning reported by Burt, in which the cure by Veratrum was prompt and decided.

I consider the Veratrum homoeopathic to two kinds of spasms, namely :

(1st.) Primarily — to clonic spasms, general or local, without rigidity, with muscular weakness, weak pulse, etc.

(2d.) Secondarily — to tonic spasms, generally opisthotonic, or contractions of the lower limbs, always with rigidity.

For the former, doses not under the 3X should be prescribed ;

• Philadelphia Medical Times, vols. ii and iii.

for the latter, below the 3X, or even the mother tincture, in large doses.

Its action on the nerves of sensation is similar to that of Aconite and Veratrum album ; yet there are points of difference worthy of being noticed. It does not actually produce anaesthesia, but allays pain and hyperaesthesia. When given in rheumatism and neuralgia the pain abates as soon as the system is under the influence of the medicine. An external application of the tincture to painful swellings, eruptions, etc., is said to mitigate the painful sensation.

Its action on the nerves of motion is very decided. “We have observed,” says Coe, “ as a result of the administration of Veratria, very singular contortions of the muscular system, particularly of the muscles of the face, neck, fingers, and toes. The head would be drawn to one side, the mouth drawn down at one corner, and the facial muscles affected with convulsive twitchings. At times these contortions would take the form of tonic spasms; while at other times the action would simulate a series of galvanic shocks, frequently of such violence as to precipitate the patient out of bed ; during all this time the intellect of the patient remained undisturbed, and he was conscious of all that was going on.” * It would certainly seem that the Veratrum was homoeopathic to cholera in some of its forms. It seems to exert primarily a sedative influence over the nerves, as specifically as Nux vomica and its analogues irritate them. Its primary action is the opposite of the primary action of Strychnine. It is homoeopathic to very many convulsive affections. As a prompt and reliable remedy I prefer it to Aconite in hysterical, epileptiform, or puerperal convulsions; also in the convulsions of children. I have succeeded with the first decimal dilution, rarely having to resort to the mother tincture, and then only giving it in one and two drop doses. The following allopathic experience with the Veratrum viride in nervous and spasmodic affections is worthy of place here. It is stated that animals poisoned with the Veratria from Veratrum viride “ lost the power over the locomotive muscles, and after death the galvanic current did not cause the same convulsive movements as in cases of

• Coe’s Concentrated Organic Medicines.

death from other causes.” * Experimenters all notice a peculiar “weakness and inability to move the muscles;” also, stiffness of the voluntary muscles. In Dr. Burt’s cases it caused trismus, opisthotonos, and other spasmodic symptoms.

Dr. Baker, in the “Southern Medical and Surgical Journal,” gives an account of the value of the drug in the treatment of certain neuroses.

Case I. — The patient was a stout, healthy man, of sober habits. I found him sitting on the side of the bed, seemingly well and perfectly intelligent, unaware, however, that he had had convulsions. All that I could ascertain of his previous history was, that he had been similarly affected in childhood. While conversing with him he was suddenly, and without apparent premonition, seized with a frightful convulsion, occasioning frothing at the mouth and the most violent jactitations of all the voluntary muscles. I immediately opened a vein and bled him profusely, but without the desired result, for, after the lapse of a certain period, with as perfect a return of consciousness as before, there occurred another convulsion of equal severity. In this emergency, the excessive muscular relaxation capable of being produced by the Veratrum viride occurred to my mind, and I reflected that such an effect could only be produced by an influence primarily exerted upon the cerebro-spinal system of voluntary nerves. I administered the Veratrum in full and repeated doses, desiring and confidently expecting to produce the same train of distressing symptoms that so alarmed me some years previously ; these were nausea, vomiting, purging (rarely observed), muscular relaxation, and coldness of the surface. In this I was disappointed ; for, though the convulsions were arrested, there occurred no other symptom than a relaxed skin, with profuse perspiration. Since then I have administered the Veratrum in numerous, cases of eclampsia of children, with such satisfactory results as to establish, beyond all doubt, the power of this agent to arrest convulsions.

In this case the cure was as certainly homoeopathic as if made with the third dilution.

Dr. Baker, in June, 1858, undertook the cure of a case of chorea in a young lady. It had been gradually coming on for two months :

When first visited her symptoms were distressing to the last degree, the entire muscular system being in continuous and tumultuous motion. The case passed on from bad to worse, notwithstanding the most assiduous attention and energetic treatment. Tonics, antispasmodics and anodynes were exhausted without avail ; the spine and nucha were cupped and blistered without benefit, Chloroform was administered internally and by inhalation, Opium and its preparations seemed to

• American Medical Times.

82G

make her worse; so, after all the family had given up all expectation of recovery, upon the suggestion of a medical friend, who had twice used the Veratrum viride in three cases of chorea with the most satisfactory results, he at once commenced its administration, and as she was gradually brought under its influence the turmoil began to cease ; the face, which had been worked by its muscles into the most ludicrous and horrible distortion, became placid and intelligent ; the head ceased its everlasting jerking, the extremities lay still, the body left off writhing, and the patient quietly passed into a peaceful and profound slumber. This sleep was deep and long, as it was the first, with few and slight exceptions, that she had had in nearly two weeks ; and the quiet that the muscles now received was all that had occurred, save during those few and short slumbers. At a subsequent visit I found the family cheerful and hopeful, and the patient quiet and sleeping, the pulse but little depressed. There had occurred no vomiting. I roused her, and, to my great satisfaction, when awake, there was no jactitation of the extremities, and but very little twitching of the muscles of the face. The Veratrum was continued ; and for the first few days, if withheld, the commotion began to return. Under the quiet induced the sleep was so continuous at the outset, that the family called the preparation “the laudanum mixture.” After a time the convulsions ceased altogether, and the patient was restored to health under a course of tonics.

Dr. Terry reports three cases of chorea in which the Veratrum viride was employed :

Case 1 was a child aged twelve. It had been confined to bed for three weeks, and was reported to have been under treatment for about six weeks ; first, for worms, with Spigelia, Wormseed, etc. ; and subsequently for chorea, with Cimicifuga racemosa, Iron, Quinine, and the usual routine treatment, until the child was apparently dying. It is not in the power of language to convey a proper conception of the truly pitiable state in which I found this child. It had slept none, neither taken any nourishment for days. It was evidently dying from exhaustion and inanition. The muscular commotion was violent, universal, and unaffected by sleep ; the lips embossed with foam, worked up by a continued champing of the teeth. Three drops of the Tincture of veratrum viride were administered every three hours, the vehicle being gum-water. In twenty-four hours 1 had the gratification to see the symptoms greatly improved; the muscles were much quieter, and the child could swallow without difficulty. The trouble in this respect had constituted the greatest embarrassment in the treatment. At the end of the fourth day all convulsive action had ceased.

Case II was an ordinary one, in a girl of fifteen. After purging, four drops of the Veratrum viride were given every three hours. Prompt convalescence ensued.

Case III. — A woman, aged thirty-six, childless, and subject to menorrhagia, immediately after an attack of which she had a continual nodding of the head and violent convulsive action in one arm, together with jactitation of one leg. In this case six drops of Tincture of veratrum viride were given every three hours. The fourth dose occasioned slight nausea, and after the fifth dose the

convulsive action ceased, when the Veratrum was withheld. In eight or ten hours the symptoms returned. Upon resuming the medicine they again disappeared. The doses were then reduced. The case recovered.

Dr. S. W. Green, of Manchester, Iowa, in a letter to Dr. Bnrt, relates a case of chorea in which the use of Veratrum was verysatisfactory :

A lady, married, about thirty years of age, nervous temperament, quite intelligent, and under easy circumstances. She has had chorea more or less from childhood up, and has been worse ever since the age of puberty, which, as near as I can learn, is in consequence of continued, intense sexual excitement, and after marriage too. She had always had homoeopathic treatment, but with little benefit, until I gave her Veratrum viride, which has been permanent. She had constant movement of the head, lower maxillary, larynx, and tongue; twitching and light jactitation of the muscles of the neck, organs of speech, and face; so much so that it required considerable effort often to converse ; constant movement, and sometimes slight jerking of the chest, arms, fingers, and lower extremities ; sometimes there would be one slight jerk of single muscles in different parts of the body. But now comes the singularity of the case. The symptoms gradually subsided, and to all appearance she was well for several months, when all at once she was taken with violent palpitation of the heart. I was called in, and found her laboring under symptoms caused by the lungs and brain receiving far more blood than was compatible with their normal condition. Her heart was beating more than 160 beats per minute. I gave her Veratrum viride, first decimal trituration, which reduced the heart to its normal action in twelve hours. There has been, once or twice since, a slight recurrence, which was speedily relieved by the same remedy. The case would seem to imply some influence upon the superior cervical ganglion.

The allopathic journals abound in reports (since 1870) of grave cases of puerperal spasms cured by Veratrum, given in ten to thirty drop doses of the tincture.

Dr. Baker also mentions a case of puerperal convulsions, in which Chloroform by inhalation, copious bleeding, and forceps were employed ; the child dead ; weighed eleven and a half pounds. Patient was left quiet and comfortable. Seen after four or five hours had elapsed. She was found in a most violent convulsion, which was said to be the seventh since delivery. Fifteen drops of the Tincture of veratrum viride were given, and ten more were directed to be given in two hours, after which the intervals should be prolonged to three or four hours. There occurred no more convulsions, and the woman recovered perfectly. She was not even nauseated, though the medicine was given at regular intervals during the whole night.

Dr. Woodward, of Galesburg, Ill., writes in the Philadelphia “ Medical and Surgical Reporter

In a late case of puerperal convulsions I did not resort to the Veratrum, but used the lancet twice, taking away forty-five ounces of blood before the convulsions ceased ; but in about four hours after the last convulsion the lady became furiously delirious, requiring to be held on the bed. Two doses, of ten drops each, of Tincture of veratrum viride quieted her so completely that she slept for four hours, and had no return of the delirium.

Since my second edition of “New Remedies” I have treated many cases of puerperal convulsions with this drug, and it has not failed to arrest them in a single case. In all the pulse was very full and hard, and the cerebral congestion was very marked.

In that fearful disease, cerebrospinal meningitis, the Veratrum viride would appear to be a valuable remedy.

Dr. C. A. Williams, of Joliet, Ill., reports the following case, presenting tetanic symptoms, but which closely resembles an attack of cerebro-spinal meningitis :

I was called one night to see a child about four years old, and found her suffering from an attack of pneumonia. The febrile action, which was excessive, accompanied with some delirium, I succeeded in reducing with the usual remedies, and with good results, as in the morning I found her quite comfortable, with the exception of a severe cough ; the skin was moist, the pulse about natural, and all the symptoms denoting a decided check to the disease, which was so alarming the night previous. This condition continued until evening, when the febrile symptoms came on again, with considerable pain in the stomach and bowels. Bowels tympanitic and very sensitive to touch. Ordered an injection, but got no relief from a very copious one; then gave Olive oil and Podophyllum, and in a few hours got a good evacuation and the removal of the tympanitis ; bowels still sensitive. In the morning bowels still sensitive, pulse quick and wiry, pupils dilated, and the muscles of the back of neck contracted, drawing the head back on the shoulders. Considerable delirium ; cough dry and spasmodic; gave Aconite, Bryonia, and Hyoscyamus. In the evening the symptoms were increased ; the tetanus still continued, extending to the trunk. At about 12 o’clock she had a convulsion or a clonic spasm, drawing the head almost to the heels. These spasms continued as often as once in five, ten, or fifteen minutes, without any relaxation of the muscles of the back for five days, when, after using all remedies recommended by the authors, and finding the patient almost gone, I asked for counsel, and Dr. Fowle was called. He advised emesis and injections, but with no effect, with the exception of some nausea. The sixth day of convulsions we used Chloroform, but got no effect. Dr. Wood came in, and the decision of all was that she must die. During this time the pupils continued dilated, bearing the strongest light without changing. It was a complete case of opisthotonos, like that produced on the dog by Gelseminum. Not having any Gelseminum I did not give it. During the spasm the heels almost touched the head, forming a hoop of the body.

From the third to the fifth day the body was covered most of the time with a cold, clammy sweat. On the fifth day there was a marked febrile action ; came on about noon, and went off in the evening. The sixth, seventh, and eighth days it was the same, when I concluded to put her on Veratrum viride. Accordingly, about two o’clock in the afternoon, commenced with half-drop doses every hour ; continued this course until twelve o’clock, when there was some nausea. On a close examination found that the muscles were somewhat relaxed ; continued the Veratrum viride until morning, when there being no fever I stopped it. I found then, however, that the muscles of the trunk were completely relaxed and the spasms ceased. In the afternoon there had occurred no return of fever, but the muscles of the neck still continued contracted ; pupils were natural, but very sensitive to light. I again gave the Veratrum viride, as before, and to my joy the next day found her able to lie on either side or back. Improvement went on from this time. I gave her Nux vomica and other medicines, and in two weeks discharged her. We had supposed that the opisthotonos was produced by an irritation of the stomach and bowels, and thus acting sympathetically on the spinal cord and base of the brain, but I have found out since that she had a fall, striking the lumbar vertebras against the corner of a trunk, three days before she was taken sick. Now, then, what action has the Veratrum viride on the spinal cord or brain ?

Dr. M. A. Tinker, of Schenectady, New York, reports a number of cases of cerebro-spinal disease, in which the administration of Veratrum was followed by the most gratifying results. These cases are so suggestive and interesting that I give them in full :

Case I. — The patient, my son, now (Dec. 1st) fifteen months old, of a nervosanguine temperament, light complexion and hair, fair, clear skin, blue eyes, fully developed, and healthy previous to the 1st of June, when he had the measles rather mildly and made a good convalescence. On the 5th of July he was taken with scarlatina ; had it very mild and made a rapid recovery, to all appearances.

On the 28th of July he became feverish and restless, and gave evident signs of irritation of the brain.

On the 29th much worse ; burning fever ; frequent vomiting ; tongue coated whitish ; bowels sluggish ; urine high-colored, of usual quantity ; very restless, and sleeps or nurses but little ; cries out on attempting to move him ; irritation extending down the spine, and both ears discharging a thick, excoriating fluid.

30th. — Every symptom aggravated in spite of Aconite, Belladonna, Bryonia, Pulsatilla, Gelseminum, etc. ; worries, with a peculiar moan, most of the time ; draws the head backwards ; rolls up the eyes ; puts his hands back of his ears and rolls the head from side to side ; pulse about 150 ; respiration rather hurried.

31st. — Continues to grow worse ; head buried deeply in the pillow; eyeballs still turned upwards ; other head symptoms about the same, only increased in violence ; bowels and urine as last reported ; discharge from the ears has become purulent and more abundant ; cannot bear to be moved at all. The pulse, to

wards evening, began to flag in strength, and at times amounts to little more than a flutter, and then the face and front of the body and extremities are quite pale and covered with a cold perspiration ; on examination I found a strip about six inches wide, extending from the crown of the head to the bottom of the spine, very pungently hot and dry, reddish in appearance, with several large and small petechia — like mosquito-bites — scattered over this inflamed strip.

August 1st. — Child very low ; the pulse at times scarcely perceptible; the case passed this day very much as he appeared last night, as reported.

August 2d. — Appears to be gradually sinking ; do not think that he can survive the day ; no alteration whatever for the better, and cannot he moved at all ; the spinal muscles are very strongly contracted. At about 1 o’clock p.m., I again took up your “ New Provings ” to see if something more could not be done. On examining Veratrum viride, a single remark there determined me to try the remedy at once. (Clinical remarks under Head.) He had cut his front teeth the week before he was taken sick ; there was no apparent irritation here. I at once prepared a solution, four drops of fluid extract in half a tumbler of water, and gave a teaspoonful every hour. In two hours the pulse began to steady, and there was less restlessness. At 6 p.m. (five hours) improvement began to be quite evident, and he slept about twenty minutes quietly. At 9 p.m. nurses ; can be moved, and turns his head; the head and spine cool and perspiring freely. At 12 M. is sleeping ; hands away from the head ; lies naturally on the pillow, and in a free, general perspiration.

August 3d. — Appears like another child entirely ; the bowels regular from the first, and at the second movement quite natural in appearance ; urine normal also ; tongue cleaning, and pulse 121.

August 4th. — Child slept very well last night, and the natural functions are all becoming regular. From this he made a very rapid convalescence. I changed the medicine once, but restlessness and head symptoms showed themselves. On returning to the Veratrum viride all subsided.

On the 5th of September, long after we had stopped all medication, the child manifested strong cerebro-spinal symptoms again, with high fever, loss of appetite, etc., as before. I gave Aconite and Belladonna, to no purpose. When I had dropped all, and had recourse to Veratrum viride, same strength as before, in ten hours all was right, and the child playing about the floor. This child has had two similar attacks since, both of which readily yielded to the Veratrum.

Case II. — September 7th was called to see a child aged three months, the first born alive of several pregnancies, and had suffered much from its birth ; of scrofulous parentage. I found the child emaciated to a mere skin-covered skeleton, with the head much enlarged and misshapen, and the sutures separated; head was drawn back as far as possible. The child also had double inguinal hernia ; the pulse about 160 .and feeble; respiration feeble and sighing; tongue coated whitish-yellow ; posterior portion of head and spine very hot ; there was so much contraction of the spinal muscles that the child was compelled to lie on his side ; the eyes rolled upward ; rolling the head, and by turns moaning and screaming ; most of the time nursed but little. He had a watery diarrhoea, mixed with white and green portions of undigested milk, and at times the discharges were quite green ; the urine scanty and high-colored. This state of things had

existed for some time, as the child had been abandoned by two attending physicians to die. I at once concluded to try Veratrum viride, four drops to a half tumbler of water, and had the pleasure of seeing my little patient amending daily, to the great delight of the parents, and in less than one week the child could lie on his back with ease ; the more alarming symptoms all disappeared, and in the course of three weeks the child had improved so much that his mother said, “ a very worrisome child has become a very good baby.” I called to see the child but a day or two since, and found a very healthy, fleshy-looking fellow.

I have had two other cases, similar as to symptoms, but not in severity, to those above reported, both of which recovered rapidly under the use of Veratrum viride.

Case III. — A boy, aged four and a half years, had for several days a croupy cough, and at night considerable fever. The cough yielded to Phosphorus, but the feverish state increased until it became nearly or quite a continuous one ; tongue coated white; urine scanty and bowels irregular, and pulse 160 to 170. About six days after the attack he had in the evening a very violent convulsion, which lasted about fifteen minutes, and considerable insensibility for an hour afterwards ; after this had passed off mostly, the fever began to increase very rapidly, and in four hours the pulse ran into a flutter, and the respiration had increased to 76 per minute. I determined to try Veratrum viride, which I prepared at the rate of six drops fluid extract to one-half tumbler of water, repeated every hour, one teaspoonful ; in three hours he was asleep, and in the morning quite comfortable, and wanted to eat. Continued the medicine from one to three hours during the two following days, and has had no fever since the night in which he had the convulsion, which was decidedly epileptiform. He has made a good convalescence and is now quite well.

The particular symptoms relieved by the Veratrum viride in all the cases reported by me were of a cerebro-spinal character. In some cases, hydrocephalic symptoms were present and had existed for some time. I have no doubt of its relieving the same symptoms, arising in connection with all other diseases, that affect spinal or cerebral, or both classes of nerves combined, which we so often meet with in warm weather.

The cases reported were from children of very large active brains.

I have used the Veratrum alone in congestion and inflammation of the lungs with very general satisfaction, my patients making speedy recoveries. I hold that in lung irritation the spinal nerves are very extensively implicated, and by using this cerebro-spinal sedative the irritation at once begins to subside, and soon all danger is past. I have the most unlimited confidence in the use of this remedy in all diseases where the spinal nerves, as well as cerebral, are concerned.

I have just relieved a case of this kind — a case of scarlatina. I tried it as an experiment, and found in a few hours these peculiar symptoms all gone and fast disappearing.

I have found Veratrum viride to act almost specifically in cases of convulsions in which there is a tendency to opisthotonos ; and the more strongly marked this symptom the more decidedly is this remedy indicated, and the more obvious its action, whether convulsions are present or not. In one case recently I produced a well-marked proving of this, and in another a very striking aggravation, even with my usual dose, four drops tincture to half a goblet of water.

Mrs. C., aged eighty-five, nervous temperament, been a sufferer for years with cataleptic spasms of the opisthotonic variety ; was relieved in a few hours of severe spasms, and has had no return for some weeks; continued the Veratrum viride once or twice a week. Considers herself cured.

Four other physicians to whom I mentioned the action of this remedy have used it and report the results very satisfactory, confirmatory of my previous statements.

I here present Dr. Burt’s case of Strychnia poisoning which I have referred to :

Two years ago I was called to a most heartrending case of poisoning by Strychnia in a noble little boy of six years of age. An old-school physician had prescribed Strychnia sugar-coated pills, each containing one thirty-second of a grain, to the boy’s uncle, for ague. How many he ate we never could learn. When I reached him he had been in spasms two hours ; the least touch of his body, the noise made in shutting the door, or the movement of his body, would bring on the most frightful spasms, lasting from one to five minutes; his arms and legs were rigid ; the muscles of the chest so rigid that respiration would cease; face livid, and bloody saliva running from his mouth. I immediately gave him nearly one teaspoonful of the fluid extract of Veratrum viride, and then two drops every ten minutes. He had nine spasms the first hour, the second but two, which were the last. The Veratrum had completely relaxed his muscular system, so that he could hardly move a limb. The third day he was up and playing about the house. The wonderful action of the Veratrum in subduing those fearful tetanic spasms, caused by Strychnia, gave me more confidence in the remedy than 1 can express.

The sleep-symptoms of Veratrum are quite commonly experienced in cerebral congestions. In the incipient stages of meningitis, or hydrocephalus, dreams of being on the water are not unusual. Dr. Coe says it is a “ soporific,” but decrees that it is not a narcotic. Drs. Tully and Ives proved to their own satisfaction that it was possessed of narcotic properties.

The Veratrum viride belongs to the group of remedies of which Aconite, Veratrum album, Gelseminum sempervirens, etc., are members. The primary action of all these remedies, when given in medicinal doses, is to depress the circulation through the nervous system. With this depression there is always present coldness or coolness of the skin, warm or cold perspiration, chilliness or coldness, and, in short, all the symptoms which generally characterize the cold stage of fevers. I have not been able to find, in any of the cases of poisoning by Veratrum viride, any general reaction

following this cold stage. The same may be said of the other members of this group. It is only in careful and exhaustive provings, with small and repeated doses, that we get continuous febrile symptoms. But we may properly accept this statement, namely, that it is with medicinal as with natural diseases a fact that a febrile reaction always follows the cold stage, if the vital powers do not prevent. Any cause capable of depressing the nervous and vascular system (primarily) will cause excitation and irritation of the same system (secondarily). The secondary (reactive) symptoms will vary in nature, symptoms, and intensity with the cause. Thus, the secondary febrile symptoms following the primary febrile symptoms of Aconite are very different from those of Gelseminum or Veratrum.

In fevers in general, Veratrum viride enjoys the confidence of a great portion of the allopathic and eclectic schools of medicine; but, like all other powerful medicines, it has its enthusiastic adherents and its bitter opposers. Some very high authorities are extravagant in their laudations of its safety, efficiency, and curative power over many diseases besides fevers ; at the same time, other authorities, equally high, denounce it as a dangerous drug. Professor Lee says :

The same objections will apply to it as has been brought against Aconite, namely, the difficulty of regulating its effect, and its dangerously depressing effects, even in small doses. From what we have seen and know of its use, we have little doubt that it has caused more deaths in one year than Chloroform has since its discovery.

I am sorry, for the sake of humanity, that I can agree with Professor Lee in his estimate of its danger, but only when used in the recklessly large doses of his school. Aconite, Tartar emetic, and Mercury are equally dangerous and fatal when used by the dominant school, yet in the hands of the homoeopathist these poisonous agents become potent instruments for the removal of disease. He regulates the dose to suit the oversensitive, diseased organism, and the result is that Veratrum viride, as well as Veratrum album, Aconite, Tartar emetic, Gelseminum, and others, become invaluable to suffering humanity.

In simple ephemeral fever, without local inflammation, but accompanied by vertigo, headache, dimness of sight, nausea, weakness, and restlessness, this remedy is as useful as any. (Drop doses of the 1st decimal dilution.)

In irritative fever it may sometimes be of great utility. In this disease the pulse often runs as high as 140, or even 160. It differs not less in strength and fulness than in frequency. Sometimes it is strong, full, and moderately accelerated, and sometimes small and feeble ; and the latter is most apt to be the case when the frequency is the greatest. When the fever is accompanied with a tendency to drowsiness, throbbing of the temporal arteries, a full, frequent, hard pulse, vomiting of mucus and bile, constipation, tendency to spasms (as is frequently the case in the infantile remittent of children), the Veratruni viride, in suitable doses, will soon effect a favorable change. To a person over ten years may be given five or ten drops of the first decimal dilution, every hour or two; to children, from one drop to five drops will suffice, although in cases of cerebral congestion large doses may be used. When this fever is caused by teething, the irritation of worms, or any cause acting through the nervous system, this remedy is the best we can use. As stated above, the pulse is often quick, febrile, and very feeble. This may arise from an affection of the nervous centres, and the pulse may be the pulse of oppression and of weakness. In the former case Veratrum viride, in the doses above mentioned, will often cause the pulse to become less frequent, fuller, and softer. When debility is the cause of the small pulse, Phosphoric acid and China are indicated.

Dr. Neidhard writes:

The Veratrum viride tincture cured the following symptoms in a boy aged twelve: Headache, with afternoon fever; dry skin; tongue coated thickly yellow ; very thirsty ; vomiting of bile ; no appetite ; constipation.

Interm ittent fever is not controlled by any remedy of the Aconite group. They do not seem to possess the antiperiodic power which is essential. I cannot subscribe to the doctrine taught in our school, that “any medicine will cure ague if indicated by the symptoms.” I practiced in a malarious district over twelve years, and my experience in the treatment of miasmatic fevers led me to adopt this conclusion, namely, that there isa certain class of remedies

which possess antidotal virtues, or are capable, when introduced into the system, of antidoting the malarious poison. I believe this poison to be a specific miasm, and not a mere “correlated force,” as some teach. Not all intermittents^ are due to the action of this poison, and some such fevers may be cured by others than members of the China group, namely, Quinine, Nux vomica, Arsenicum, Salicin, Cornus, Eucalyptus. Veratrum viride, although not indicated for the disease itself, is often of great use in the hot stage, when the action is intense and the vascular system is excited strongly. In such cases, in adults, we may have congestion of the brain, delirium, powerful action of the heart, and a hard, rapid pulse, and in children severe spasms and convulsions. In these cases this remedy is superior to Aconite or Belladonna. Under its use the intensity of the paroxysm will soon subside, and the threatened convulsions be arrested. I have sometimes given one or two drops of the mother tincture, every half hour, to an adult, and half as much to a child, with the happiest results.

Remittent or bilious fever, when not dependent on miasmatic* influences, will often be amenable to the therapeutic influence of Veratrum viride, but will have to be alternated with other remedies, like Bryonia, Mercurius, Podophyllum, or Leptandra, as the symptoms and conditions demand. When the gastric symptoms are predominant this remedy will have to be used in smaller doses (2d or 3d dilution) than when the stomach and bowels are irritated. When this form of fever assumes the character of a pernicious remittent, the Veratrum viride must be used with extreme caution. It is still indicated, but 'primarily, for the primary action of the drug is to cause conditions very similar to a pernicious fever, namely, a prostration of the vital forces, with typhus symptoms, etc. My experience in such fevers has taught me that the best and safest treatment is to use Baptisia, Veratrum viride, Aconite, or Veratrum album 3d, in alternation with a remedy secondarily indicated, namely, China, Quinine, Nitric acid, etc., in material doses. Indeed, it is often necessary in those low conditions which occur during pernicious fevers to give Quinine in five or ten grain doses, repeated, in brandy, every hour. Those who have had to combat these terrible malarious diseases will know and appreciate the necessity of resorting, in

some cases, to such doses ; and those who know the least, practically, of these diseases, are they who are loudest in denouncing what they term “ gross medication.”

In yellow fever the Veratrum has been used by the allopathic school with alleged success. Drs. White and Ford, of Charleston, S. C., treated many cases with Veratrum viride. In the Charleston “ Medical Journal and Review” they give the results of their treatment. They gave from eight to ten drops to adults, and from one to six drops to children, repeated every hour or two:

By the administration of the Veratrum in this manner the pulse was sooner or later subdued, and as it sank became somewhat irregular. The first doses were often vomited, in severe cases, but the succeeding ones were commonly retained, and the patient did not vomit again until the pulse was reduced, when the effect of the remedy was occasionally marked by emesis. This vomiting was rarely severe, ceasing of itself upon a temporary discontinuance of the medicine, or yielding readily to common restoratives. The reduction of the pulse was accompanied by notable cooling of the body, by a well-marked diminution of the headaches, pain in the back and limbs, of the restlessness and anxiety, of the frequency of the respiration, of the congestion of the skin, flushing of the face, tumefaction of the tongue, and injection of the conjunctiva. The patient felt much relieved and slept tranquilly as soon as the vomiting had ceased ; nor would the symptoms tend to recur for some hours, as they would always do, however, if the drug were not again prescribed. The pulse kept by the Veratrum beats fifteen below the normal range. If the pulse was small and frequent, it was given in small doses ; if black vomit supervened and the pulse was slow> the Veratrum plainly was not required ; if, however, the pulse was rapid, the Veratrum was continued in doses proportioned to its frequency, which were usually small and repeated every two or three hours. Without regard, therefore, to the ordinary accidents of the disease, whenever it was required, and only then, the Veratrum was uniformly or specially administered, until convalescence was declared. Together with the Veratrum, however, Mercury was given, pushed to salivation and catharsis ; also saline, diuretic, and refrigerant mixtures ; so that the results are anything but satisfactory to the investigator who would ascertain the pure effects of drugs in disease. Of the whole number treated with Veratrum, namely, 117, there recovered 102, died 15. Adults 80? recovered 66, died 14. Children 37, recovered 36, died 1. The subjoined table shows the mean range of the pulse under the Veratrum viride, as compared with its mean range before the Veratrum was given :

Mean frequency.

Adult Males.

Adult Females.

Children.

When Veratrum v. was first given,

102.5

114.2

137.5

Seven hours after, .

61.3

65.2

71.0

Remainder of disease, .

52.8

64.7

74.8

This table shows the power which the medicine exercises over the pulse and the heart’s action in disease, and by it we can judge pretty correctly of its action on the healthy organism.

In typhoid fever the Veratrum viride has not been used much in homoeopathic practice; not as much as, in our opinion, it is entitled to. Many of its symptoms strongly resemble the symptoms of typhoid, particularly the abdominal and cerebral varieties. The only cure on record in our literature, illustrating the action of this remedy in typhoid fever, is reported in the Philadelphia “ Journal of Homoeopathy,” by Hr. Henry. He says :

It is the best remedy I have ever used in the treatment of those diseases which have a tendency to assume a typhoid form of fever. As far as I have been able to test this remedy in fever of all descriptions, I must say I am better pleased with it than with Aconite.

Case I. — A little girl, aged thirteen, had been suffering with continued fever for ten days. She complained of violent pains in the back ; inclined to sleep most of the day ; very sick at the stomach, but not so as to produce vomiting ; black diarrhoea ; pulse varying from ninety-eight to one hundred and ten during the day ; pain and weakness in the lower limbs. I took the case to be a mild form of typhus. I immediately put five drops of the mother tincture in a tumbler half full of water, and ordered a teaspoonful to be taken every half hour, until perspiration was produced. I called in two hours, found the pulse down to 84 ; the patient was in a general perspiration ; she recovered without any other remedy in two days.

Case II. — Mr. II., a young man, aged eighteen, sick two weeks. Found him with a very high fever ; pulse 120 ; face very much flushed ; fulness, with slight pain, and great buzzing in the head ; gnats and bugs fly before the eyes ; inclined to jump out of bed ; talking at random ; slight bearing-down pains in the bowels, attended with black diarrhoea; great weakness of the lower extremities, with general prostration. Six drops of the mother tincture of Veratrum viride were mixed with twelve teaspoonfuls of water, a teaspoonful to be taken every half hour. In three hours found the pulse down to 95 ; before the day was out he was in a fine perspiration ; no fever for three days ; has now a slight fever, which lasts two or three hours a day ; every other symptom right.

There is no question in my mind but that a continuance of the pathogenetic action of Veratrum viride would result in such lesions of the intestinal canal as results in the typhus process. Rubbed on the skin or held in the mouth it causes erosions and vesicular eruptions, and it will probably affect similarly the whole intestinal tract. I regard it as secondarily indicated in all fevers of the synochal or inflammatory type, and even

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in some typhoids. The above cases have many symptoms which resemble those caused by Veratrum viride ; but Baptisia, Belladonna, Phosphoric acid, and Muriatic acid are more generally indicated.

I do not consider my duty to my colleagues properly performed did I not give allopathic testimony as regards the use of this medicine in typhoids. A little truth may be gleaned from the chaff bv careful winnowing.

Dr. Staples (allopath), of Dubuque, Iowa, says:

Veratrum viride has been condemned in some of our Eastern hospitals in asthenic cases attended with much prostration. For instance, typhoid, fever, on the ground “ that we have already a weak, feeble pulse, and the Veratrum would only make it weaker.” Now, any observer who has carefully observed the action of Veratrum viride, has observed that the pulse, as it was reduced in frequency, became fuller and stronger, while the fact that it causes nervous sedation should not be lost sight of. It should also be borne in mind that the views of modern investigators in reference to the agency of the nervous system in pathology and therapeutics, essentially modify the treatment of disease. It is a fact well known to pathologists that similar phenomena often attend totally opposite conditions of the brain, for which no satisfactory explanation can be given. There are functional derangements, watchfulness, etc., attendant upon superexcitation of the brain, while the debility and depression of the nervous system, which explode into delirium tremens, are followed by kindred phenomena. But in either case the continuance of the disturbance enhances the primary affection, and by so much removes the system from convalescence. Take, now, typhoid fever. True, there is a rapid, feeble pulse, but the very excitation and irritation which grow out of cerebro-spinal debility and increased vascular action perpetuate the disturbances, augment the very debility, and wear out the system by excessive friction. In this condition the secretions are locked up, the brain is oppressed, the heart and lungs are laboring to free themselves from t he tension to which they were subjected. Now here is a condition in which remedies cannot act. But if we can subdue this nervous exaltation, the system becomes relaxed, the secretions are restored, the circulation and respiration become slower, fuller, and stronger, the lungs oxygenate the blood more completely, and nutrition and depuration, which had been before impossible, are allowed to go on. I have seen typhoidal cases where the morbid action had continued for weeks, with the pulse from 110 to 130, speedily convalesce on reducing the cardiac pulsations by Veratrum viride to 70 or 80 per minute.

Dr. S. submits the following hypothesis of the action of Veratrum viride, under which it may be serviceable in cases of debility, under certain restrictions, and at the same time valuable as an antiphlogistic :

The administration of Veratrum viride, carried to a limited extent, allays, by its action upon the cerebro-spinal system, nervous and circulatory excitability, and places the system in a favorable condition for recuperation • another degree produces profounder impressions by attacking the sympathetic system, which presides over secretion and nutrition, inducing sedation and constitutional depression, evinced by the rapid waste, emesis, diuresis, and diaphoresis.

The testimony of the eclectic and allopathic schools as to its usefulness in low forms of fever is about equally divided. In small doses, in the dilutions, it will undoubtedly prove useful in typhoid and other low fevers, if homoeopathic to the symptoms and conditions.

Finally, besides the above general indications for the use of Veratrum viride in fevers, there are two characteristic symptoms which should always be present:

(1.) A very hard, full, quick, hounding pulse. (Aconite has small, very quick, hard, sharp pulse; Gelseminum, a quick, full, large, but soft pulse; Baptisia, a quick, full, bounding, but easily suppressed pulse.)

(2.) A tongue yellow at the sides (edges) with a red streak, wide or narrow, in the middle. (Aconite, yellow, or white all over; Gelseminum, pale red or yellowish-white; Baptisia, dark red or brown.)

On the muscular and fibrous tissues the Veratrum viride has an undoubted and perhaps direct effect, similar perhaps to Bryonia, Belladonna, Colchicum, Cimicifuga, etc.

In some clinical remarks upon the Veratrum viride the late Dr. J. C. Peterson reported the cases below, illustrating its action in rheumatism:

Case I. — Mr. S., aged thiity-seven, sanguine, nervous temperament, was attacked with violent rheumatic pains in the left pectoral region, and elbow of the same side. The pain was so severe that he was delirious. I gave him Veratrum viride 1st, one drop every fifteen minutes ; perfect relief followed the exhibition of this drug within an hour. He fell asleep and perspired profusely. Although of a decided rheumatic diathesis he has had no return of a similar attack.

Case II. — Master F., eleven years of age, was attacked with violent inflammatory rheumatism of the left knee. The part was much swollen, but not discolored ; impossible to move the limb on account of the agony it produced. Gave Veratrum viride tincture, one drop every half hour until relief from the pain resulted, then a dose every three hours. In twenty-four hours he fully recovered, and has since remained well.

Case III. — Miss P., aged twenty-six. Was attacked with severe pain in the left knee, which prevented the use of the limb. I found her excessively nervous and with some general fever. Gave Veratrum viride tincture, one drop every hour. In a few hours complete relief followed the use of this drug.

Case IV. — Mrs. H., aged forty-two, of a decided scrofulous diathesis, was attacked with rheumatism of the left hip and leg. The pain was severe and the limbs restless. Gave Veratrum viride tincture, a dose every two hours, one drop, which relieved her of her suffering in forty-eight hours.

Case V. — Mrs. H., aged forty, nervous temperament and subject to dyspepsia, had severe, agonizing pains in the right shoulder, extending along the scapula and into the back of the neck. The arm was paralyzed and immovable, pulse accelerated and tense, tongue coated white. She had been in this condition for several days, with aggravation at night, so as to preclude sleep. Gave Veratrum viride tincture, one drop every hour. The effect of a few doses was to produce profuse perspiration, and to bring about relief from her sufferings. Rhus tox. was given in alternation with Veratrum viride to relieve the paralyzed condition of the arm. This case fully recovered in a few days.

It will be observed that all these cases occurred upon the left side. I have been led to look upon Veratrum viride as a specific for all this form of trouble. In neuralgia I do not think it equal to Belladonna , Aconite, Spigelia, or Kalmia.

Dr. J. C. Peterson expressed his opinion that,

In all inflammatory conditions where we find a complication with the stomach, I prescribe Veratrum viride in preference to Aconite. Thus in catarrhal fevers we often have nausea and perhaps vomiting, even at the onset of the disease. For such cases I use the Veratrum viride, even though Aconite might be indicated by the purely inflammatory symptoms. I have succeeded with the happiest results by this course.

Its action on the mucous membranes is probably extensive. Like Tartar emetic, it will cause hyperaemia, and even acute inflammation if applied locally, or even by its internal administration. In the latter instance, however, its action is secondary. In all the inflammations of mucous surfaces it has been praised by physicians of both schools.

Dr. A. V. Marshall, of Vermont, reports the following cases of catarrhal inflammation, treated with Veratrum :

Case I. — Miss T. called at my office, complaining of a cold which caused her to cough very much. Gave Aconite and Pulsatilla. About a week later she sent for more medicine, saying that she coughed more than ever. I prescribed for her several times during the next two months, with little or no benefit. By this time all the neighborhood was alarmed, as they supposed Miss T. must die

soon of consumption. About this time I thought best to find out what ailed my patient, for I had given little attention to the case before, as I supposed the trouble was protracted by taking new cold. At this time, I found hard pain in the forehead, above and between the eyes, extending towards the back part of the head ; for chest symptoms I found only slight bronchial irritation. She coughed hard day and night, and could sleep only one or two hours out of twenty-four; raised thick, white or yellowish matter; most in the morning, or after getting a little rest. At times she felt something tickling down the back part of the throat, as she said. I diagnosed catarrh of the posterior and superior nares, and prescribed Veratria 2d trituration, the bottle of it to be shaken so that the dust of the powder will rise freely, and held under the nostrils while inhaling the breath once in four hours. The result was speedy and permanent cure.

Case II. — Mrs. M - . In her imagination she is afflicted with almost every

malady that ever she heard of ; thinks she is going to die, and wishes she could die, and yet she “ would not die for all the world ; ” just such a patient as no one likes to doctor; one particular symptom was hard and constant burning pain above, between, and back of the eyes ; discharge from the nose and throat of what she compared to thick starch. She has been under the care of an allopathist for months. He tells her that her stomach is out of order ; that the head symptoms are sympathetic, etc. (?) Ordered Veratria, as in case first, and a weak infusion of Cypripedium, one spoonful three times a day. Three days later she was the same, except that the catarrhal discharge was more profuse ; ordered the snuff (Veratria) to be taken only once a day. She improved rapidly, took the snuff less frequently as she gained, and in two weeks she was able to attend to the household duties, and was about as good as new. I have used the Veratria in the same form in numerous cases with perfect satisfaction.

We have no proof in our proving, or in the cases of poisoning on record, that it causes any eruptions when taken internally ; externally it causes erythema and vesications. Professor Lee says it is an u epispastic ; ” it causes perspiration, not like Opium, which stimulates the skin, but like Tartar emetic. In other words, the sweating is passive, from depression of function. In allopathic practice the Veratrum viride has been used externally in local inflammations. The tincture should be combined with Glycerin, two parts to six. Apply by saturating lint, and putting it on the inflamed spot. It is reported to have cured a case of shingles, applied externally in the form of diluted tincture. In chronic skin diseases it has been used, according to Professor Lee, with much benefit. A popular ointment for the cure of scabies, tinea capitis, etc., is made from this plant, but its external use in such cases is not devoid of danger.

In the febrile exanthemata the Veratrum viride has proved efficacious in homoeopathic practice.

In small-pox or variola, when the fever is intense, with excessive pain and restlessness, the Veratrum viride will prove as reliable as Aconite, and, in some cases, even more satisfactory. I have used it in but one case of variola ; four drops of the 1st decimal were given every hour, with the effect of mitigating the severity of the fever and hastening the occurrence of the eruption. The recent use of the Sarracenia purpura in this dreaded disease now attracts much attention, and bids fair to supersede all other remedies.

Dr. Holcombe, of New Orleans, thinks highly of the use of Veratrum viride and Macrotin in variola. He says :

Small-pox I have always regarded as a self-limited disease, running a specific course, and very slightly modified by medicinal measures. I passed through a dreadful epidemic of it at Natchez, in 1863, and have seen a good many cases in this city in the last six months. Tartar emetic, Causticum, Croton tig., Mercurius corrosivus, Thuya and Variolin have been my mainstays, and I have every reason to be satisfied with my treatment, the mortality being very small ; still the natural history and course of the disease has been pretty much that described in the books for the last hundred years; Lately I noticed that Dr. Wilkinson, of London, had great confidence in Veratrum viride for small-pox ; and remembering that Dr. Hill, in his epitome, and Dr. Smith, of Chicago, had recommended Macrotin in the warmest manner, I determined to alternate the two. I began on a very severe case. The constitutional symptoms were violent, and the patient was thickly peppered with the eruption, although it was not confluent. I gave Macrotin, one-tenth of a grain, and Veratrum viride, one drop of the mother-tincture, alternately every two hours. The case went along very smoothly,; the vesicles did not go on to full maturation ; the great majority of them flattened rapidly, dried, and fell off’. I had never seen so rapid a cessation of the disease before, nor so prompt convalescence. I have pursued the same treatment in three more cases, all with the same result. It will take a vast amount of evidence to prove that anything can abort the development of the variolous poison, but the aboye cases are certainly valuable. Nothing else whatever was employed except bathing some portions of the skin in warm whiskey and water to relieve the intolerable itching, which is sometimes so distressing.

In measles, during the febrile stage, and especially if pulmonary congestion is feared, the Veratrum viride is a most useful remedy. Under its use the dyspnoea, cough, and pain rapidly subside. In children convulsions often precede the outbreak of the eruption. If Veratrum viride is given at the outset, this accident will generally be prevented. The next most useful remedies in this disease are Gelseminum, Pulsatilla, Euphrasia, and Sticta.

In scarlatina it is infinitely superior to Aconite, Gelseminum, or any other remedy except Belladonna. I allude to the scarlatina simplex and scarlatina anginosa during the first or febrile stage. It controls the pulse, even when given in the low dilutions, better than any other remedy, and hastens the normal appearance of the eruption. The testimony of some of the most prominent physicians of the homoeopathic school sustain this assertion. Dr. Small prefers it to any other remedy when the arterial excitement is intense, and there is danger of cerebral congestion or irritation of the spinal centres. It is well known that in this disease the arterial excitement is more severe, the pulse more frequent, and the heat of the skin greater than in any other; the Veratrum viride will sooner modify this condition than Aconite or Gelseminum. It should be given in alternation with Belladonna ; the doses must be varied to suit the severity of the case. For children, the dilutions from the first to the third decimal ; for adults, drop doses of the mother tincture may be required. The best rule is to give enough to control the arterial excitement.

It is useful in certain sequelae of scarlatina, viz., rheumatism and cellulitis, when febrile symptoms are manifested. In erysipelas it is often useful. Besides its specific action in controlling the arterial excitement, it appears to be homoeopathic to the vesicular variety; for the application of Veratrum viride to the skin often causes an eruption closely resembling that form of the disease, and even its internal administration is said to have caused a similar eruption all over the body. When cerebral symptoms occur from a supposed metastasis of the inflammation to the brain, and we find the pulse very hard and very full , we may expect much benefit from this remedy in alternation with Belladonna, Apis, or Arnica. If the febrile symptoms assume a low or asthenic type, Rhus tox., Arnica, Muriatic acid, or Baptisia, will be more applicable. The Veratrum viride has been used, as an external application, with alleged benefit in cases of erysipelas; a weak solution, one drachm to one pint of water, may be applied with soft cloths.

Since the first edition of this work, the use of Veratrum viride,

in erysipelas, internally and externally, according to ray suggestion, has been adopted with successful results.

Dr. Wilkinson, of London (England), praises it highly — is rather too enthusiastic in fact. In his work he gives several cases illustrating its efficacy, but the cases he gives are not quite satisfactory.

Dr. Drummond, of England, also values it highly in erysipelas. He uses a lotion of thirty drops to half a pint of water, applied constantly to the diseased surface by means of lint. He reports three cases; the first, a case of erysipelas of the face and scalp, in which the lotion, in a few hours, sufficed to disperse the redness and swelling, whilst the pain was mitigated from the first application of the lotion :

Case I. — Mr. N., aged sixtv-two, employed in a gas-works, called upon me on the 12th of June, 1865. He had been spending a few days in the country, and had been exposed to excessive sun-heat. His face was greatly swollen, and the eyelids so much puffed that he could only find his way with difficulty, and he complained of the burning and stinging pain of the face. He had applied, during the two previous days, cream and buttermilk, and had taken some aperient medicine, but without the slightest relief. As there was little constitutional disturbance I simply ordered him to use the Veratrum viride as a lotion to the face, by means of lint moistened with it. This gave relief, and I heard no more about him except through his son.

Case II. — Miss T. D., aged nineteen, after an exposure to damp during the catamenial period, was attacked with erysipelas. I did not see her at the onset of the disease, but she had been advised to take Belladonna and Rhus alternately, and to apply a saturnine lotion to the face. She disliked this lotion, and at last refused to use it, and gin and water was substituted by her friends. The next day I visited her; the nose, eyes, and forehead were much swollen, and the scalp was very sensitive to pressure to the vertex, although it did not appear puffed. The only change suggested in the treatment was the substitution of the Veratrum viride for the other lotions. Amendment at once set in, and she was convalescent within a week, and she spoke most favorably of the effects of the Veratrum.

Case III. — Mrs. G., aged forty-six, a stout, plethoric lady, with a strongly marked gouty diathesis, was taken ill on the 21st of May, 1865. She had been sitting on the lawn watching some friends play croquet until late in the evening ; after returning to the house she had a severe rigor, followed by pungent fever and distressing, throbbing headache. I saw her next day, pulse 100, tongue coated and dry, thirst, headache, severe pain in the right leg, and complete inability to move it. Upon examining the leg, found it intensely red from the ankle to above the knee, swollen and oedematous, the skin looking as though it must burst. Low diet, Aconite A, and Belladonna A, alternately, and dressed the leg

I

with strips of lint, moistened with Veratrum lotion, which were covered with oiled silk. In the evening the fever less severe, the headache still most intense ; ordered Rhus and Belladonna, and the lotion to be continued.

May 23d. The headache most distressing, the leg looks paler, but the erysipelatous blush has extended up the back of the thigh. Lotion to be applied to these parts, to take Mercurius vivus A, gr. ij immediately, and then continue the Belladonna and Rhus. Evening, the headache is so intense she declares she must go mad if she does not get relief, and is annoyed at my expressing a wish to examine the leg, which she says is comfortable ; the erysipelas less ; ordered Glonoin i and Apis mel. b, and the lotion to be continued.

May 24th. — After the first dose of Glonoin fell asleep and slept tranquilly for two hours. Head much relieved ; leg better. From this date she gradually improved, and it is not necessary to detail the daily symptoms. Several weeks elapsed before she regained sufficient strength to move about, the leg remaining so much swollen that she could not put a stocking on. She, however, gradually improved from day to day, and went to Weisbaden, in July, for the benefit of her gouty symptoms, from which place I have received most favorable accounts of her progress.

The Veratrum viride acts upon the brain similarly to Aconite and Gelseminum, yet their effects are far from identical. The therapeutic range of Veratrum over affections of the brain is far greater than that of the latter. I know of no drug, not even Belladonna, so useful in affections of the head when they are of a congestive character. In cerebral congestions it is immensely superior to any known drug. This assertion is made understandingly, and based upon an experience of twenty years with it. It is most useful when the congestion arises from 'plethora, vascular irritation, coup de soldi, alcoholic stimulants, teething in children , and especially when it occurs from suppressed discharges. When the congestion occurs from rheumatic irritation, Cimicifuga or Aconite are better indicated. The symptoms calling for Veratrum viride are: a sense of fulness; weight or distension of the head ; giddiness ; intense headache, with fulness and throbbing of the arteries, sometimes with stupefaction ; increased sensitiveness to sound, with buzzing, roaring, etc. ; double, partial, luminous, painful, dim, or otherwise disordered vision; nausea and vomiting; tingling, numbness, etc., in the limbs; mental confusion; thick speech ; loss of memory ; convulsions or paralysis of motion.

For the congestions of the head in young children, from teething, I have for several years given this medicine the preference over Belladonna or Aconite ; also in cerebral oppression occurring

during the progress of a pneumonia. I consider it as perfectly homoeopathic to these before-mentioned congestive conditions as any other drug in our Materia Medica, for it has caused all the symptoms of such morbid states. It does not cure by depressing the vital powers, as bleeding does. Those who denounce the use of Veratrum viride in vascular irritation, fever, etc., might as well denounce Aconite and Gelseminum, for they all act in a similar manner. The increased action of the vascular system is a secondary effect of these medicines.

In meningitis the Veratrum viride should be used promptly, in the lowest dilutions, alternated with Belladonna, when the latter remedy seems indicated. I believe it to be more useful in this disease, as well as cerebritis, than Aconite. In tubercular meningitis or hydrocephalus, it can do no good, except in the stage of active inflammation, if that stage exists ; but it may be palliative in preventing or arresting spasms in the later stages. Three cases occurring in my own practice will illustrate its usefulness in congestive headaches.

Case I. — Five drops of Veratrum viride, one-tenth, three times a day, cured a case of habitual congestive headache which had troubled a young and plethoric lady for over six months. She took the medicine four weeks. From having attacks every day or two, they came only once a week, and finally subsided entirely.

Case II. — A young, stout, and very plethoric servant girl, had intense congestive headache at each menstrual period (the menstrua were very scanty and painful). The attacks were almost apoplectic, rendering her delirious or insensible, with dark-purple redness of the face, throbbing of the carotids, epistaxis, and partial paralysis of motion, and sometimes cramps. No hysterical complication was present. After taking five drops of Veratrum viride, one-tenth, as follows, three times a day during the intermenstrual period, and every hour during the attacks, she was much benefited, the menstrua were more abundant and the headache slight. The second period was much more natural, with very little headache.

Case III. — Intense congestive cephalalgia, from suppression of the menses. Bleeding had been decided upon by another physician (an allopathist), but at my suggestion to the family the Veratrum viride was tried. Ten drops of the one-tenth, every thirty minutes, relieved her in two hours, and the menses reappeared.

A plethoric gentleman of this city has attacks of intensely congestive headaches ; he becomes stupid, has ringing in the ears,

bloodshot eyes, thickness of speech, hot head, and a slow pulse (70) full, and hard as iron. Bromide of potassa never relieves him, but a few doses of Veratrum (two drops 0 every half hour) always gives him relief.

Most of the effects of Veratrum upon the ears and eyes arise from a depressed state of the circulation. The same condition is present as after excessive bleedings, or loss of any of the vital fluids. In high potencies it may prove useful in similar affections. But Veratrum viride causes, secondarily, congestion of the brain, with ringing of the ears. In low dilutions it is one of the best remedies for the latter condition. It is well known that anaemia and plethora will produce nearly the same array of brain symptoms, although opposite pathological states are really present. Thus, acute hydrocephalus is often simulated by the hydrocephaloid disease which arises from sheer debility.

It is primarily homoeopathic to amaurosis from ancemia, or from loss of fluids, or from debility during convalescence (should be alternated with China, Phosphoric acid 1st), and given in the 6th dilution. It is also indicated in amaurosis from irritation or congestion of the optic nerves, when the symptoms correspond with its pathogenesis.

The Veratrum viride produces undoubted inflammation of the mucous membrane of the oesophagus, with superficial erosion, spasm, etc. We have here a truly homoeopathic remedy for oesophagitis. It is also homoeopathic to spasmodic stricture of that tube.

Its action on the stomach is quite similar to that of Veratrum album, Tartar emetic, or Arsenicum. It is evidently homoeopathic to cardialgia, gastralgia, and neuralgic or spasmodic affections of the stomach, when accompanied by vomiting, retching, and excessive irritation. Dr. Burt considers it the best remedy in such cases, better than the Veratrum album. He uses it at the 3d or 6th. It should not be given lower. It should prove curative in gastritis, erosion of the stomach, and ought to palliate the pain and vomiting in cancer of the stomach. It causes all the symptoms of pyrosis, waterbrash, and many of the symptoms of “ dyspepsia.”

There is no reason why Veratrum should not be an excellent remedy in vomiting. The act of vomiting, however, should be attended by some peculiar symptoms, either (a) loss of power over

the oesophagus, in which the vomiting is painless, or (6) intensely painful mucous irritation of the oesophagus, with burning, rising of bloody mucus, and very severe cramps in the stomach and spasms of the oesophagus, empty retching, etc. Like the vomiting of Veratrum album, the slightest quantity of food or fluid is ejected, but it has not the intense thirst of that remedy.

There is nothing very peculiar about the substances vomited. I consider the empty, painful retching, with ejection of a little bloody, frothy mucus, as the chief indications.

The liver and portal system must be affected by this drug, as it affects other organs. By its primary effect it causes venous stasis in the portal circulation, but I have not discovered its special usefulness in this condition, nor should I consider it indicated unless the pulse was very weak and very slow.

A microscopical examination of the liver of dogs killed by Veratrum showed intense capillary engorgement. In hepatitis, during the first stages, it should be a capital remedy. It will be indicated more by the absence of acute pain than its presence. It is well known, particularly since Inman called attention to the fact, that inflammation of the liver, lungs, pleura, and peritoneum may occur without any of the sharp stitching pains which are generally considered as belonging to such conditions.

Veratrum, unlike Aconite and Bryonia, is not indicated by the pain, soreness, etc. The intense fever, the hard pulse, and the usual physical signs are its best indication.

Of its action on the spleen we know very little.

In the uraemia which attends the last weeks of pregnancy and precedes convulsions, the kidneys are very torpid (acutely congested), and the pulse becomes intensely hard. Here we shall find the Veratrum a most powerful remedy for arousing the kidneys to action, causing the elimination of urea and lessening the dangerous arterial pressure.

It is agreed by all allopathic medical writers who speak of this plant, that it irritates the bowels much less than Veratrum album. Some, however, claim that it should not be used in diseases where any intestinal irritation exists. Wood, however, does not mention it as a purgative. Dr. Coe remarks :

The employment of Veratrum viride in the treatment of diarrhoea and dysentery affords occasion for some remarks in regard to the action of this remedy upon the bowels. We have seen it stated by some writers that Veratrum is objectionable on account of its irritating influence upon the intestines. Such has not been our experience. We have employed it much in the treatment of bowel complaints, and with the most happy results.

Yet he admits that it has an “ emeto-cathartic” action, and says it is contraindicated in “intestinal ulcerations.” He says it is useful in all cases of “ torpor and debility of the abdominal organs,” and is of utility in mania, epilepsy, hysteria, convulsions, melancholy, etc., when arising from “functional obstructions of the abdominal viscera, and disturbed and discordant action of the abdominal nervous plexus.” All this, however, is quite conjectural, although it is apparently indicated in abdominal congestions. Dr. Norwood says “it is not cathartic,” but he speaks of “avoiding its drastic effect,” and mentions that “ the only cases in which we have seen it purge were when given in combination with Tartar emetic. In most of these cases it excited a violent cholera morbus .” Concerning its therapeutic effects he states: “ We have found it of great value in the treatment of typhoid dysentery, and would feel unable to combat that disease without it, or some other remedy of equal power.” It seems homoeopathic to about the same condition of the bowels as Veratrum album ; also to haemorrhoids.

Its action on the kidneys has been pretty well investigated by allopathic observers. Professor Lee says :

Its diuretic action has been established by numerous experiments. It is worthy of particular note that it does not act as a mere renal hydragogue, but like Colchicum it increases the solid constituents of the urine. While it increases the amount of organic and inorganic solids, it is not positively established that it augments the quantity of the uric acid. Like Colchicum it increases the amount of the urine, as well as the total amount of the solids eliminated, but it is pretty generally certain that this is mainly dependent on an increase of organic matter. Its curative influence in gout and rheumatism may thus be explained. It is said to eliminate lithic acid through the kidneys.

Dr. Abbott made some experiments which proved that it causes a considerable increase in the amount, and a corresponding decrease in the specific gravity of the urine. It would seem to be

homoeopathic, primarily, to certain forms of diuresis, enuresis, and perhaps diabetes. It is curative in acute inflammation of the kidneys and bladder.

We have yet no symptomatic proving of Veratrum viride upon the female organism. It is said to have caused abortion in numerous instances, yet Drs. Ford and White, who used it so freely in yellow fever, thought it prevented that accident. It may not cause abortion directly, as Sabina or Cimicifuga, but indirectly, by the great prostration of the general symptoms, the severe efforts to vomit, etc. In the same way it would cause haemorrhage from the uterus. It is probably homoeopathic, primarily , to passive congestions of that organ. My experience with the Veratrum viride, in this class of diseases, is confined principally to acute inflammation of the uterus, or puerperal metritis , in which I place a high estimate upon its value. I think I have arrested the inflammation, or materially modified it, by the use of the lower dilutions. There are certain conditions attending uterine disorders in which the Veratrum viride has proved very successful in my hands. I allude to those congestions of the head or lungs which occur during uterine disorders, such as menstrual congestions of the head (menstrual headache), also congestion of the head and lungs from suppressed menses, suppressed lochia, etc. In these accidents, a few drops of the lowest dilutions has never failed to prove promptly curative in my practice. It is highly recommended by Dr. Miller (eclectic) in dysmenorrhoea occurring in plethoric subjects ( i . e., congestive dysmenorrhoea). In anaemic subjects he pronounces it decidedly injurious. It is probably indicated in this affection for similar symptoms to Aconite and Belladonna.

Acute congestion of the uterus causes scanty menses. When this disorder is present in plethoric women, and is attended or not by congestion to the head or chest, give the medicine in drop doses of the tincture.

Congestive dysmenorrhoea comes under its curative sphere. Dr. Eggert, of Indianapolis, made a brilliant cure of this condition with Veratrum viride. Although a stanch partisan of the high dilutions, he used the lowest in his case with very excellent results.

In acute metritis and ovaritis, attended with a high grade fever,

no remedy is more efficient. It equals Apis in 'pelvic cellulitis ; in fact, to treat a case of this grave disease successfully without the two remedies is next to impossible. They will often prevent suppuration if given in time.

Puerperal peritonitis is most successfully treated (if high fever is present) with Veratrum viride and Opium (both in appreciable doses).

In idiopathic orchitis, its internal administration, aided by its local application, often acts magically. If the inflammation be traumatic, alternate it with Arnica or Hamamelis; if gonorrhoeal, with Pulsatilla, Clematis, or Erigeron, and Hamamelis topically. The treatment of orchitis by means of strapping is a great aid to internal remedies.

The treatment of mastitis, when the breasts are very hot, hard, and engorged, is most successful when Veratrum viride and Phytolacca are given alternately, and cloths wet in a lotion of Phytolacca are applied.

Dr. A. C. Barlow, of Toledo, writes :

For violent menstrual colic previous to the occurrence of the discharge, I use Veratrum viride tincture in drop doses, repeated every half hour or hour. It is invariably followed by a marked mitigation of suffering and the establishment of the periods. I could cite from my note-book hundreds of these cases.

It has been found useful in palliating violent attacks of hysterical convulsions. Many allopathic writers, among them Dr. Simpson, of Edinburgh, extol it highly in puerperal fever. It may prove useful in the vomiting, pyrosis, and other symptoms occurring during pregnancy. Many of the symptoms occurring during the change of life are simulated by this medicine. In acute mastitis, with high febrile action and great tumefaction of the breasts, I have used it alternately with Belladonna with very satisfactory results. It has been used boldly, recklessly, by the allopathic school, in puerperal convulsions (eclampsia) as a substitute for bloodletting, but in such doses as to be nearly or quite as pernicious as the abstraction of blood. I have never used it in that affection, but I have administered it in cases where I thought convulsions would ensue if not warded off, and with the apparent result of preventing that terrible array of symptoms. In puerperal mania it has proved curative. (See a case reported by Dr. Woodward.) Dr. Atlee reports a case as follows :

The labor had been preternatural ; child delivered dead, by podalic version. She did well until ten days after confinement, when she became silent, suspicious, and distrustful of those about her, without any obvious cause. In the hope that the change was temporary, opium and perfect rest, with careful watching, was enjoined. Two days after, symptoms of puerperal mania were still more developed ; it was impossible for the doctor to come near her, his presence seemed to terrify her, and her husband told him that since the last visit she expressed strong apprehensions that the doctor had poisoned her and meditated her destruction. She had slept little or none, and it was difficult to keep her confined to her bed and room. In the hope that some benefit might result by controlling the general circulation and diminishing the nervous excitement, five drops of the tincture were given every three hours, as long as it did not produce nausea, vomiting, or prostration. On the following morning, on entering the room, he found his patient lying quietly and calmly on the bed, with a total absence of the sinister expression of the day before. She answered him slowly, but in a whisper, put out her tongue, and let him feel her pulse without resistance. Upon inquiry he found that soon after the administration of the third dose of Veratrum on the previous evening, she had become calm, had rested quietly, and had remained so. Pulse fifty-six. She was cheerful and obedient, conversed rationally and freely, and without allusion to her previously unhappy condition. She recovered perfectly in a few days.

Dr. Coe states that a majority of the cases of mental aberration arise from and are dependent upon a morbidly increased activity of the nervous structures of the abdomen. “ This,” he says, “ would seem to explain why Veratria is of utility in the treatment of mania, melancholy, and mental weakness.” (Very doubtful.) “ In cases of mental aberration, acorn pan ied with torpor and debility of the abdominal organs, Veratrum will be found serviceable.” (Mere theory.)

The symptoms of Veratrum relating to the chest consist only of ‘‘great oppression ” and “heavy weight.” But the physical symptoms are very important. It decreases the number of respirations to twelve or fourteen in health.

In dogs poisoned with Veratrum there was found “ violent congestion of the lungs, especially the lower lobes.” In cats both lungs were engorged.

In the second edition of “New Remedies” I wrote as follows :

In Dr. Burt’s proving, made on himself, he makes no mention of any pains

which may be termed pneumonic, or pleuritic ; the pain in the heart only was noticed. It is a notable fact, however, that in the provings of Tartar emetic we have the same absence of acute thoracic pain ; yet the latter drug has a high reputation, even in the homoeopathic school, in the treatment of pneumonia. It is well known by all practical physicians that severe cases of pneumonia may run their course with little or no pain at any time being present. The Veratrum viride has not been extensively used by homceopathists in the treatment of thoracic diseases. Satisfied with that time-honored remedy, Aconite, they prefer to adhere to that drug. But many of my colleagues, both East and West, agree with me in considering the Veratrum viride as superior to Aconite, in pneumonia in particular. My own experience with it has so far been satisfactory. In the incipient stage of that affection, when simple engorgement only exists, I believe it has the power of arresting the disease, and in the later stages it proves a valuable auxiliary to such remedies as Bryonia, Phosphorus, Tartar emetic, and Sanguinaria. I usually give the lowest dilution (ten or fifteen drops of the 1st dec.), every thirty or sixty minutes to adults, and half the quantity to children. In a few cases only have I been obliged to resort to the mother tincture. In one case, that of a strong robust man, five drops were given every two hours ; after ten hours, profuse vomiting with sweating set in ; the previously intense fever subsided, and did not return, and a rapid convalescence followed. It was given on the third day of the fever, when there was bloody sputa, severe oppression and pain in the chest (left side), and all the physical signs of the first stage of pneumonia.

Seven years have now elapsed since that was written, and I have had no occasion for changing my opinion. I have been criticized for asserting that Veratrum viride has the power of arresting 'pneumonia in the first stage. From the language of some of my critics I do not think they are aware of what the first stage consists. One of the best authorities thus defines it as “ a stage of congestion, in which the affected portion of the lung is of a deep red color; crepitates under pressure, though less than in health ; and when cut, exudes copiously a bloody, turbid, and somewhat frothy serum. . . . If the disease be arrested in this stage the lung reassumes the healthy appearance.” Another great authority (Stokes) maintains that the congestive stage is preceded by another, “ marked by intense arterial injection with dryness — in other words, a condition of irritation — which always precedes inflammation.”

Now it is evident that these two conditions rarely exist separately. They must blend together in a majority of cases, and it is in these conditions — the first stage of pneumonia — that Veratrum is useful.

What are the symptoms which attend this first stage? They

are (a) more or less chilliness (although that may be wanting), (6) great heat and oppression of the chest, with sensation of a heavy load on it; rapid, laborious breathing, with or without pain; short, dry cough, etc/ I still assert that if Veratrum viride is indicated in this stage it will arrest the disease, and rapid resolution will take place. What indicates Veratrum viride? The character of thepulse. If you find a fall , hard , hounding pulse, that cannot he obliterated hy the pressure of the finger , give Veratrum. The pulse need not be quick. It is the hardness of the pulse and its fulness that calls for this remedy. If the pulse is hard, quick, and small, Aconite is indicated. My experience confirms me in the opinion that the dose in such conditions should be about one-tenth of a drop every half hour, and in severe cases one or two drops, until the pulse becomes compressible. So soon as this occurs decrease the size of the dose, or suspend it altogether after a few hours, for it is only in the stage of irritative congestion that Veratrum is indicated in the low dilutions. In the second and third stages it should be used above the 8X, if at all, and in alternation with Tartar emetic, Sanguinaria, or Phosphorus.

Dr. Ringer, of England, in his “ Therapeutics,” says it is used and recommended in both sthenic and asthenic pneumonia. He specially quotes the experience of Dr. Drosch, who used it in seventy-three cases with good results, with the effect of “ lessening the pulse, lowering the temperature 1° to 3° C., quieting the breathing, changing the character of the expectoration to a light-yellow color, rendering it scanty, and calming the patients.” “ It did not appear,” he says, “to shorten the acute stage, but seemed even to lengthen it, retarding the resolution of the lung, and caused vomiting and diarrhoea.”

It is evident that Drosch committed the great error of all allopathists, of giving it in too large doses, and continuing its use too long. By following my directions, and substituting the proper homoeopathic remedy after the first stage, rapid resolution will ensue, and the violence of the disease will be greatly modified.

Drs. Patton and Lee (allopathic), of this country, give the following excellent testimony, and it is a notable fact that they decry the large doses in use by that school. They say :

Pneumonia is the disease in which Veratrum viride is particularly indicated. It seems to have more controlling power in this than any other disease, reducing the inflammation and favoring the expectoration in a very few hours ; in some instances vomiting is induced, which is generally of tough viscid mucus ; the pulse now rapidly declines, if not affected before ; the breathing becomes very easy, and the patient falls into an easy sleep, with, perhaps, a gentle perspiration. The dose, now, is to be managed so as to sustain the depressed circulation. I find that in pneumonia it is better to reduce the pulse as soon as possible. The inflammation being in a degree arrested, the lung is saved from the more severe consequences of the second stage, or that of red hepatization, from the concrete fibrinous exudation being caused by a peculiar inflammatory action ; thus, the cause being in part removed, this exudation is in a great degree arrested, and the patient, in a majority of cases, enters into a favorable convalescence.

As to the use in asthenic cases of pneumonia, I am of the opinion that it is primarily indicated by the prostration, the feeble, oppressed pulse, the passive stasis in the lungs, and the low grade of inflammation. Veratrum viride differs from Gelseminum and Aconite in its power of causing primarily a kind of typhoid condition, in which it somewhat resembles Baptisia. It should therefore be given above the 3X, and in alternation with Phosphorus.

In pleuritis it is not indicated, unless in the stage of irritative congestion. The same might be said of its value in pleuro-pneumonia. The indications which I have given for its use in pneumonia must be your guide.

I have never used it in diaphragmitis , but I predict it will prove a useful remedy in that rare disease, in which it will probably rival Cactus.

Acute inflammatory diseases of the heart, at their onset certainly call for the free use of Veratrum. Experiments have proved that it causes death by paralyzing the muscular structures of the heart, by poisoning the nerves leading to the heart, or by acting on the cardiac ganglia in the substance of that organ.

It is primarily indicated in cardiac oppression, with passive congestion ; cardiac debility, with fainting and collapse therefrom. In those heart affections occurring during prostrating diseases, after haemorrhages, etc., it may be used, but always in the minutest doses. No remedy exercises a more depressing action on the heart than the Veratrum viride in large doses.

It is secondarily indicated in increased activity of the heart, after previous depression. In carditis and pericarditis it has been used

with alleged success by allopathic practitioners. In rheumatic affections of the heart it is especially lauded, but may do as much injury as bleeding if used in large doses. Having an action similar to Aconite, it will, perhaps, be found as useful as that medicine in heart affections. It does not, however, cause that intense cardiac anxiety, with fear of death, which Aconite does. It will be found palliative in many organic diseases of the heart, but should be used with great caution.

It is not a “ cardiac tonic ” in material doses, as Digitalis is said to be. It will alleviate, according to my experience, those palpitations attended with faintness, or dyspnoea, which occur in many diseased conditions of the heart, or attend the “ change of life” in women. Some of the symptoms felt by Dr. Burt resemble those found in the pathogenesis of Spigelia. It may be a matter of doubt whether the “ burning sensation ” experienced by Dr. Burt was really in the heart; the oesophagus may have been the seat of the sensation.

Dr. Seudder (eclectic) says that he has ascertained by actual clinical experiment that the Veratrum viride, in small doses, is as much a “cardiac tonic” as Digitalis is in large. This effect is due to its primary homoeopath icity to a weak condition of the heart, which it causes in pathogenetic doses.

In all asthenic cases, when the heart’s action is slow and feeble, small doses (the 3X or 6X) will rally the failing vitality in a manner similar to the Veratrum album , to which it is very closely related.

The question arises : Is Veratrum viride indicated in any chronic structural diseases of the heart? I believe it is, and in my practice it has done me good service in hypertrophy with dilatation, used as a continuous remedy, not as a palliative. In your studies of the action of Veratrum album you will remember the statement that it has been used by soldiers and others to cause “ pseudo-cardiac diseases,” which so closely simulated the organic as to deceive the medical examiners. Dr. Muller gives many such cases ; the disorders thus caused resembled hypertrophy with dilatation, or even valvular lesions ! The ultimate primary effects of Veratrum viride will cause very similar conditions, and when given in small

doses (3*) alone, or alternated with Nux, Ignatia, Collinsonia, or Digitalis, will do good service.

It may be of service in the treatment of cardiac disorders marked by irritability from weakness.

It ought to be homoeopathic to those cases of cardiac failure, or cardiac syncope, which come on suddenly while in apparent health. It might be tried in the 30th dil. But as such cases generally occur in hysterical subjects, Sumbul or Ignatia are probably more useful.

When cardiac hypertrophy, with enlargement, causes intense pressure of blood in the head, no better remedy can be found than Veratrum viride (one or two drops of the tincture until the fever is lessened).