The first case is that of a woman with chronic metritis and prolapsus uteri. Hydrarg. chlorat. mit. was given at first, which acted favorably on the inflammation, but whose further use was prevented by its giving rise to salivation. The intumescence of the uterus continued about the same. Chloride of gold entirely reduced the chronic inflammation, and restored the uterus to its natural position without external means.

INDURATION OF UTERUS.

The second case was an unmarried woman at the climacteric, the v.a.g.i.n.al portion of whose uterus showed an induration which disappeared during the administration of chloride of gold.

HYSTERICAL SPASMS.

The third case was a woman with periodical attacks of hysterical spasms, which involved the entire body, with unconsciousness lasting several hours, asthma, palpitation, etc., beginning with a sense of coldness, ascending from the abdomen, and perceptible even to the bystanders.

Sometimes the attack began with pulsation through the occiput.

Examination showed an inflamed uterus, filling not only the true pelvis, and interfering with urination and defecation, but the enlarged uterus perceptible through the thick abdominal walls above the p.u.b.es. At the end of seven months, _Aur. mur. nat._ had entirely reduced the swelling.

The woman has enjoyed good health for several years, quite free from the so-called hysteria.

INDURATION OF CERVIX.

It happened that a woman presented an induration of the cervix, together with a remarkable softening in the posterior uterine wall. The result of treatment with chloride of gold was, that in proportion to the decrease of the induration there was an increase in the consistency of the softened posterior wall. The woman, who had been married for three years and childless, became pregnant for the first time and has since borne several children. With this experience, the Gold-chloride was also given for a softening of the atrophied cervical ca.n.a.l, in one case until it was curved at right angles to the body of the uterus; also in a diffused softening of the uterine tissues, with the result that the hitherto sterile woman, after toning up the uterine tissue, attained the joy of motherhood. * * * * *

Habitual abortion and premature labor recurring at about the same month of pregnancy generally depended upon induration in some portion of the uterus, which, preventing its natural expansion during gestation, gives rise to premature expulsion of the foetus. By the use of _Aur. mur.

nat._ before and during pregnancy, the absorption of this induration will conduce to the proper termination of parturition.

A swelling of the ovary, reaching as far as the umbilicus, I have cured with _Aur. mur. nat._, and have improved others of considerable extent very decidedly. Martini has cured five cases of ovarian dropsy in the greatest possible degree with the same remedy.

Ulcers of the os and the v.a.g.i.n.al portion, which had resulted from inflammation and induration, some as large as a dollar, and of a gangrenous character, were healed by the use of gold, without any topical applications.

The profession considers ulceration and induration of the uterus incurable. This dogma of theirs is based on the fact that the usual change, the disturbance of nutrition, can neither be remedied nor hindered in its advance. Now since ulcers are generally found only in an advanced stage of softening and induration, it is conceivable why the school--seeking a cure solely in the use of local means--turns away almost entirely from the employment of internal remedies. According to the opinions of the specialists the use of different remedies, partly insoluble, partly soluble, pure or in combination, permanent or transient, is indicated. Others apply ointments on sponges to the surface of the ulcers, keeping them in contact with it by tampons.

Others again prescribe injections, and with these expect to attain the end. Finally, glowing-hot iron, the galvano-cautery, or the knife and scissors remove partially or entirely the v.a.g.i.n.al portion.

Now, if the malady continues to thrive on the wounds made by these procedures, if old cicatrices break out again, if too a permanent cure is out of the question, there is ground for supposing that the _product_ of illness, the ulcer, may be cauterized, burnt and cut away, but that the cause, the diathesis, the tendency to it, can only be removed by internal medication. * * * * *

CHRONIC METRITIS.

One day an official in Dresden brought his wife to me, who was 41 years of age. The couple, all of whose children had died soon after birth, longed once more for children. The woman had aborted several times, and both were intelligent enough to see that everything could not be right with the s.e.xual organs, and even begged for a gynaecological examination.

The result was in a few words: inflammation of both lips of the uterus, a thickening of the cervical ca.n.a.l with a swelling of the posterior uterine wall as hard as cartilage, and retroversio uteri. Menstruation too early, dysmenorrhoea, blood dark, tarry, pa.s.sing in clots.

Yellowish, fetid leucorrhoea. Stools retained, appet.i.te changeable; pains in the broad ligaments on both sides during rest as well as on exertion. The so-called "facies uterina"--weeps much. Frequent exclamations on the distastefulness of life since the death of all her children, and on account of her present childlessness. Should I register in my journal in the beginning of a scirrhus? I wrote simply: metritis chronica; intumescentia labiorum orificii et colli uteri.

Prognosis, not unfavorable as far as regards the swelling, after my already well-tested experience with _Aur. mur. nat._ But how about the removal of sterility acquired in her 41st year. I was more cautious about this. The cure took six months, and was not only accompanied by absorption of the affected parts, but the woman became pregnant in good time and gave birth to a boy with comparative comfort. Thus would the wishes of the worthy couple have been fulfilled, if their joy had not been banished once more by the death of the child in four weeks from an attack of eclampsia.

ANTEVERSION WITH PROLAPSUS.

I now come in conclusion to a gratifying case, which I relate partly because we make ourselves guilty of sins of omission in certain instances through neglect of the needful investigation. A woman in her twentieth year, quite healthy, had been delivered with forceps for the first time two years before, nominally on account of deficient labor pains. There was nothing unusual about the confinement. Immediately after the first getting up, she began to have constant pain in the right side of the uterine region, and soon a feeling "as if something would fall out of the parts." The family physician paid no attention to these persistent complaints for a whole year, until finally a constantly increasing leucorrhoea demanded an examination. He now expressed himself as unable to make a diagnosis alone, and the lady was referred to a celebrated gynaecologist in Leipsic. Cauterizations were now undergone at the professor's house at short intervals, and further treatment of a similar character was to be carried out at the patient's own house, which was, however, discontinued when the patient was referred to me. Examination showed: metritis following upon sub-involution of the uterus, anteversion with prolapsus of the whole organ. Both uterine lips were swollen, and on examination with the speculum a greenish-yellow discharge was seen to flow from the uterus.

All local treatment was discontinued, the woman received for the first time in April, 1876, _Aur. mur. nat._, and in June, 1876, again became pregnant; the treatment with gold was continued until the 8th month of pregnancy, in consequence of which the uterus was found in its normal position on examination twelve days after her safe confinement on March 30th. The menses, which up to this time had been very painful, returned for the first time on the 25th of April, and were quite free from suffering.

But now let us ask, whether we have in the salts of gold a simile for the diseases of the female s.e.xual organs under the comprehensive name of chronic metritis. We find in the h.o.m.oeopathic proving, inflammatory affections of the internal organs; fainting depression and emaciation; great anxiety, sadness, dizziness, whimsical mood, weariness of life, morbid desires, and headache; nausea, vomiting; pressure in the gastric region; cardialgia, contractive, drawing pains in the abdomen.

_St.i.tches in the left hypochondrium, pinching and burning in the right_, the abdomen sensitive to touch, with distension; dull pains in the abdomen; drawing and stinging in the whole abdomen; eruption of small papules above the p.u.b.es; _decreased excretion of urine_, pressure on urinating, burning on urinating; redness, burning, swelling and moisture of the l.a.b.i.a, _discharge of yellow mucus_, menstruation too soon and lasts too long; amenorrhoea; labor-like pains, as if the menses would appear; symptoms which certainly correspond to the whole picture of chronic metritis and its results.

The mode of administration which I have used for _Aur. mur. nat._ is in trituration. Generally I have had the patient herself divide into three parts a 10 gr. powder of the 3d trit., and take one of these dry just one hour after each meal. But I have also used the 1st and 2d trituration. The effect cannot be seen before four weeks, hence I seldom make a further examination before that time. Many women notice a remarkable increase of the appet.i.te during the use of gold. After the administration of the 1st trit. I have observed frequent, dark stools.

An increase in the urine with a thick, gray sediment is often seen.* * *

UTERINE DISEASES.

Uterine diseases, according to my experience of many years, make more marriages unfruitful than all the other known or fancied hindrances to child-bearing. They can exist many years even with a blooming appearance, without apparently disturbing the general health, and on that account are often overlooked and mistaken by physicians themselves, who are not concerned about gynaecological examinations, or else make only superficial investigations, not having their eyes at the ends of their fingers. I beg, therefore, if this communication should give rise to a more extensive use of _Aur. mur. nat._, above all things, a thorough gynaecological examination, not leaving this to the so-called surgeons and midwives. If women complain of gastric troubles, dizziness, pain in the loins and back, disturbances of urination or defecation, with a more or less p.r.o.nounced hysterical appearance, and withal purposely or unwittingly deceive themselves and the physician; if, added to these, leucorrhoea and a sensation as if everything would drop out of the abdominal cavity, one may say of the patient that her uterus is diseased, and may base upon that his proposal for an examination, which will give the correct information of the nature of the malady. As a rule, every deep-seated, morbid alteration in the uterine tissues entails suffering upon the nervous system, which, being in such close relation with the uterus, not seldom apparently suffers the most.

HYSTERIA.

Because the uterus receives its nerves from the sympathetic system, which governs nutrition, circulation, respiration with distribution of animal heat, gestation, etc., these functions being out of sight, it is difficult to get at the root of the matter as regards the uterus in a suffering woman. Her sensations and fancies offer, according to her education, organization, etc., a wide field in which to make her a burden to herself and others. Her mind is generally out of order, she knows not why. In the more advanced stages of disease, the functions of the higher nervous system, the organs of sense, and even the mental activities are disordered. Then appears that chameleon of diseases, which goes by the name of _hysteria_, suitable in so far as hysteria almost without exception takes root in the "hystera" or uterus. I shall certainly not deny the possibility of primary or purely nervous diseases of the uterus, hysteria sine materia; I am nevertheless convinced that in at least nine cases out of ten, hysteria depends upon objective, sensible, perceptible changes in the uterus. It is these whose existence I ascertain by a thorough examination, and according to these that I regulate my treatment; they give me in every case a more certain starting point than a lengthy account of true and imaginary suffering.

If I find, however, no palpable abnormality in the tissue to remove, and prescribe _Aur. mur. nat._ simply as an excellent nervine, following Niemeyer, it occasionally does good, but generally leaves me in the lurch.

AVENA SATIVA.

NAT. ORD., Graminaceae.

COMMON NAME, Oats.

PREPARATION.--The fresh green plant, gathered in August, is pounded to a pulp and macerated with two parts by weight of alcohol.

(Comparatively little has been written concerning this remedy, the tincture of oats. It acquired a bad reputation somewhere in the "eighties" by being advertised as a proprietary remedy making wonderful cures, but a.n.a.lysis showed the advertised "avena" to contain opium. The following outline of the drug is by Dr. E. H. Russell, in _North American Journal of h.o.m.oeopathy_):

_Avena sativa_ is pre-eminently an anti-neurotic, quieting the nervous system to a remarkable degree. Its special sphere of action seems to be upon the male s.e.xual organs, regulating the functional irregularities of these parts perhaps as much as any drug can. It is a most useful remedy in all cases of nervous exhaustion, general debility, nervous palpitation of the heart, insomnia, inability to keep the mind fixed upon any one subject, etc., more especially when any or all of these troubles is apparently due to nocturnal emissions, masturbation, over s.e.xual intercourse, and the like. For these disorders it is truly specific. It is one of the most valuable means for overcoming the bad effects of the morphine habit. In most cases in which the habitue has not used more than four grains daily the opiate may be abruptly discontinued, and even subst.i.tuted, without any serious results. If a larger quant.i.ty than this amount has been taken for some time, it is better to gradually reduce the daily dose of morphine, in the usual manner, simply prescribing the _Avena_ in addition. The latter should be given in the same dose, as a rule, regardless of the amount of morphine taken. In other words, it is not necessary to increase the _Avena_ as the opiate is withdrawn. When the quant.i.ty of morphine has not exceeded four grains daily it should be stopped at once, as stated above, and _Avena_ given in its stead in fifteen-drop doses, four times a day, in a winegla.s.sful of hot water. By this method the disagreeable after-effects will be much less than though the dose of morphine is gradually reduced, and the patient will find life quite bearable, as a rule, at the end of a week.

_Avena sativa_ should always be given in appreciable doses of the tincture. Fifteen drops three or four times a day, well diluted, will usually meet the case. It may be given in doses of from five to sixty drops in rare instances. It should, however, never be given in larger quant.i.ties than twenty minims unless the patient is thoroughly accustomed to the remedy, and has found the usual dose insufficient.

Otherwise there is danger of getting the physiological effect of the drug, which is _pain at the base of the brain_. When this symptom makes its appearance the medicine should be discontinued for a day or two, and then given in reduced doses. There seems to be no danger whatever of forming the habit of taking this drug, as it can be suddenly abandoned at any time without evil consequences, even when given in large quant.i.ties. In one case it was prescribed by the writer in sixty-drop doses, night and morning, _for one year_, and then abruptly stopped, nothing being subst.i.tuted therefore, without bad effects.

Whenever a quick action is desired, and in all cases where _Avena_ is given to overcome the morphine habit, it should be prepared in hot water. It is also a good plan to prescribe it in this fashion wherever indigestion complicates the case.

The writer has employed this drug in his private practice for a number of years with the most gratifying results. He has very rarely found it to fail when indicated, and on account of his high opinion of the remedy he has taken great pleasure in thus bringing it prominently to the attention of the medical profession.

AZADIRACHTA INDICA.

PREPARATION.--The fresh bark is pounded to a pulp and macerated in two parts by weight of alcohol.

(The following synopsis of _Azadirachta Ind._, is contributed by P. C. Majumdar, M. D., of Calcutta, India):

_Azadirachta Indica._ Syn.: Sanskrit, Nimba; Bengala and Hindi, Nim.

Belongs to the natural order Meliaeae. It is a large tree. Bark is used for making tinctures from which provings were inst.i.tuted. The leaves, bark, wood, roots and fruits, in short, every part of this tree, is intensely bitter. According to Ayurveda (Hindu System of Medicine) the different parts of this tree possess different medicinal properties.

Bhava Misra, Charak, Susratha and several other Sanskrit authors agree that its bark, though very disagreeable in taste, is generally used with success in cases of la.s.situde, thirst, cough, fever, loss of appet.i.te, helmenthiasis, boils, bilious derangements, catarrh, vomiting, cutaneous diseases, hiccough, gonorrhoea, etc.; its leaves are used in some forms of ophthalmic disease, helmenthiasis and disorders brought on by deranged bile or use of poisonous things. A decoction of fresh leaves is used as a favorite wash to cure old ulcers of long standing. It removes within a short time the sloughs and promotes the healing. The fruit is purgative, demulcent, and is used in some forms of cutaneous affections.

A kind of oil is produced from the seed of ripe fruits, and this oil is said to cure lepra, eczema and some other obstinate skin diseases.

Nim is also praised by some of the Allopathic physicians for its tonic, antiseptic, astringent and anti-periodic properties. Its febrifuge action is well-known in our country. Kanirages (native physicians) use Nim as the princ.i.p.al substance in their febrifuge medicines. The vast range of its action is chiefly due to azaderine, margocine and katechin, the three active principles found in this tree. Nim was proved by me and one of my students, U. C. Bagchi. A full report of the proving was published in the _Indian h.o.m.oeopathic Review_, Vol. iii, No. 1. Here I give the most reliable and peculiar symptoms obtained in its proving.

Mind: Depressed and forgetful, mistakes in writing and spelling words, weak and dull, full of anxiety, inactive, could not think or remember names of persons very familiar, or what has been done in the previous day. No desire to go out or walk out. Loss of memory.

Head: Giddiness, as if the head were moving to and fro, especially when rising from a sitting posture; headache, pressure in the head, by moving it; headache, throbbing in the temporal arteries, especially of the right side, with a little vertigo; aching, drawing and throbbing in the whole head; headache, by wet compress, with much pain in the right eyeball; headache, on moving; headache on the right side with much pain.

Frontal headache, especially on the right side, in the open air.

Throbbing in the vertex, by stooping; scalp is painful and sensitive to touch, even the hair is painful. Vertigo at 10 A.M.; intense headache, pain in the whole head; on walking pain is felt in the back part of the head.

Eyes: Burning in the eyes; burning of the eyes continued throughout even the next day; burning, dull and heavy. Pain in the eye, by slightest pressure; red, congested and burning with slight coryza; sense of pressure in the right eye; eyes red and sunken; pressive pain in the right eyeball.

Ears: Buzzing in the ears; a peculiar cracking sound is heard in the ear like tickling with a feather, which is increased on opening the mouth.