Nose: Running of watery fluid from the nose.

Face: Flushings of the face; flushing and heat in the face; face pale.

Mouth: No thirst but mouth is clammy, water has relish; taste good, but mouth is clammy and bitter. On the sides and surface of the tongue a painful burning sensation is felt as if scalded; papillae seem to be enlarged and prominent. Putrid taste in the mouth. Saliva coming out which tastes salty. Slight difficulty in deglut.i.tion, especially water and meat.

Throat: Bitter taste in the throat; left-sided sore throat.

Stomach: No thirst; appet.i.te very acute and keen; very great thirst for large quant.i.ty of cold water; very great thirst at long interval.

Heart-burn and water-brash. Uneasy sensation in the thorax.

Abdomen: Great uneasiness in the abdomen with flatulent rumbling in the bowels; twisting pain in the epigastric region; no tenderness in the abdomen; clutching pain in the umbilical region, obliging to bend forwards, which affords some relief; abdomen a little distended, pa.s.sing of offensive flatus; painful tension in the hypochondriac region.

Stools: Insufficient; bowels very much constipated; stools hard, small and knotty; stools hard, but natural; stools copious, soft, semi-solid.

Diarrhoea, no satisfaction after stool.

Genito-urinary organs: Great excitement of s.e.xual organ (in male); s.e.xual desire a little diminished. Urine scanty and high-colored, and scalding; urine white, clear and copious; urine of strong odor (once with purple sediment).

Respiratory organs: Very troublesome cough after bathing at 1 P.M. Sputa white in small lumps expelled with much difficulty. Sighing, breathing at intervals. Slight hoa.r.s.eness. Cough with greyish expectoration; cough with thick sputa; short, dry cough in the afternoon; very troublesome cough with white sputa and tasteless. Deep breathing at long intervals; breathing very rapid and hot.

Chest and throat: Aching in the lower part of the right chest, below the nipple. St.i.tches in the chest. Crampy pains in the lower part of chest.

Transitory st.i.tches in the chest, especially in the right side.

Pulse, quick and hard, feeble.

Neck and back: Pain and debility in the nape of the neck.

Extremities: Numbness of the limbs, as if the limbs are paralyzed.

Gnawing in the legs. Strength of the hand diminished. Burning of the hands and soles of the feet. Numbness of the hands only, especially the right hand. Rheumatic pains in the lower extremities.

Sleep and dreams: Sleeplessness and tossing in bed; dreamy and interrupted sleep at night. Dreams of quarrels and beating in the latter part of night.

Fever: Fever commences with very slight chill or without chill from 4:30 P.M., and abates from 7:30 P.M.; afternoon fever. Glowing heat and burning, especially in the face, eyes, palms of the hands and soles of the feet, in open air.

Copious sweat, especially on the forehead, neck and upper part of the body; sweating commences on the forehead, gradually extending towards the trunk; no sweat in the lower part of the body.

Skin: Itching of various parts of the body, without the appearance of any eruption; itching of the body. Sudamina on the back.

BACILLINUM, TUBERCULINUM AND AVIAIRE, THE VIRUSES OF TUBERCULOSIS.

PREPARATION.--Triturate in the usual way.

(The literature on these several preparations is so extensive that we must confine ourselves to the paper read by Dr. Francois Cartier, Physician to the Hospital St. Jacques, Paris, at the International h.o.m.oeopathic Congress, 1896, it covering the ground more completely than any other. For fuller information on _Bacillinum_ the reader is referred to Dr. J. Compton Burnett's book, the _New Cure for Consumption_.)

I must disclaim any intention of traversing afresh the pathogenesy of _Tuberculin_, or of inst.i.tuting an examination into the various treatises put forth on the subject of the virus of tuberculosis by the allopathic as well as by the h.o.m.oeopathic school.

The materia medica of _Tuberculin_ takes its rise in the complex result of the use of Koch's lymph, in experiments upon animals, and in certain symptoms observed by those who have experimented upon themselves with different products of tuberculous nature. I shall therefore indicate the published sources, and I specially desire to place before the h.o.m.oeopathic Congress of London the tuberculous virus under certain aspects which are perhaps new; and if my conclusions seem somewhat paradoxical I am content to accept, with a good grace, the criticisms of my colleagues.

Fourteen years anterior to the researches of Koch, Hering, Swan and Biegler availed themselves, as a h.o.m.oeopathic remedy, of the maceration of tuberculous lungs, and of the sputa of tuberculous subjects.

Dr. J. Compton Burnett in his book, "A Cure for Consumption," several years before Koch's experiments, noticed symptoms resulting from taking the preparation which he calls _Bacillinum_.

Drs. de Keghel[C] and J. H. Clarke[D] inst.i.tuted an inquiry into the symptoms produced by the employment of Koch's lymph in the case of tuberculous and non-tuberculous patients.

[C] _L' Union Homeopathique_, vol. v, No. 3.

[D] _h.o.m.oeopathic World_, vol. xxvi, No. 304.

Dr. Mersch[E] published a pathogenesy, based to a large extent upon that of Dr. de Keghel; it is an excellent work.

[E] "On Tuberculin," an extract from the _Journal Belge d'

homeopathie_, 1895.

Dr. d'Abzen,[F] of Lisbon, sent to the Tuberculosis Congress of 1895, at Coimbra, a study of the works of Koch and Pasteur, and an enumeration of the treatises published by h.o.m.oeopathists.

[F] _Pathogenese, sua importancia._

We must notice also an English translation of Dr. Mersch's pathogenesy, by Dr. Arnulphy, of Chicago, in which special attention is paid to the symptoms observed in healthy and non-tuberculous persons, with some original remarks about _Tuberculin_. It is published in the _Clinique_ for this year (February, 1896).

Nor must we overlook a series of writers who have published isolated observations of the cases of persons cured with _Tuberculin_. Such are Drs. Lambreghts, Joussett, Zoppritz, Horace Holmes, Richardson, Young, Clarke, Pinart, Youman, U. H. Merson, Snow, Lamb, Clarke, Ebersole, W.

James, Kunkel, A. Zoppritz, Steinhauf, Van den Berghe, &c.

Finally, for my own part, in my articles in _L'Art Medical_, published three years ago, and in the _Hahnemannian Monthly_ (July, 1894), I have insisted on h.o.m.oeopathic action of the viruses of tuberculosis.

In certain of the pathogenesies of _Tuberculin_ we find thrown pell-mell together symptoms appertaining to Koch's lymph, as well as others which belong to the product baptized by several names, such as _Bacillinum_ and _Tuberculin_, in the recommendation of which Hering and Swan, and Dr. J. Compton Burnett, in England, have made themselves conspicuous.

_Bacillinum_--since it must be distinguished from Koch's _Tuberculin_--is a maceration of a typical tuberculous lung.[G] Koch's lymph is an extract in glycerine of dead tuberculous bacilli. The former is compound natural infection; the latter is a product of laboratory experiment. In the one, various bacteriological species are a.s.sociated which give, clinically, an appearance of cachexia and of hectic fever; from the other we may sometimes observe vascular, cardiac, renal changes having no connection with the clinical "syndrome" of pulmonary tuberculosis. To place these products together in the same pathogenesy gives an absolutely wrong sense, and the fact that both contain Koch's bacillus gives no excuse for confounding them. In my opinion there are, from a h.o.m.oeopathic point of view, distinct differences between _Bacillinum_ and the Koch's lymph.

[G] Dr. J. Compton Burnett, in his book, "New Cure for Consumption," p. 129, makes this remark: "The best way to get some really good _Bacillinum_ is to take a portion of the lung of an individual who has died of genuine bacillary tuberculosis pulmonum, choosing a good-sized portion from the parietes of the cavity and its circ.u.mjacent tissue, as herein will be found everything pertaining to the tuberculous process--bacilla, _debris_, ptomaines and tubercles in all its stages (such was practically the origin of the matrix of my _Bacillinum_) and preparing by trituration in spirit. In this way nothing is lost."

Experimentally Koch's bacillus, like many other microbes, does not reproduce a clinical symptom-group; and we h.o.m.oeopaths must have an a.s.semblage of clearly-defined symptoms before prescribing a poison on h.o.m.oeopathic principles. Such is unfortunately the case with many other microbes in pure culture. The experimental diphtheria does not resemble clinical diphtheria. The pneumococcus, pathogenetic of pneumonia, is met with in many other diseases, such as pleurisy, salpingitis, meningitis, etc. Koch's bacillus, too, sometimes remarkably mild in its effects, and seeming to meet with no reaction in the system, evolves aside as in the verrucous tuberculosis; while at other times nothing is able to arrest the action of this terrible microbe, and the world still waits in vain for the man who shall find the means of combatting it. The toxins of tuberculosis are far from reproducing clinical tuberculosis; yet even here we find a curious aspect sometimes a.s.sumed by certain poisons drawn from the pure cultivation of microbes.

We cannot produce with _Tuberculin_ symptoms a.n.a.logous to those of real tuberculosis--as it is possible, for instance, to produce teta.n.u.s with the toxine alone, _Tetanin_.

As a general rule, in the case of a healthy man, Koch's lymph would not develop any reaction, its effects manifesting themselves in a febrile congestion, which betrays the presence of tubercles. In our pathogeneses (those of Mersch-Arnulphy), we note the following symptoms--"catarrhal pneumonia with soft hepatisation, and tendency to abscess formation; at post-mortems it is not a gelatinous or fibrinous exudation which oozes out from the alveoli, but an opaque and watery fluid; 'never,' so says Virchow, 'is there found the characteristic lesion of croupous pneumonia.'" A pneumonia from which issues an aqueous and opaque liquid! I confess I do not understand it.

Experimentally this same lymph of Koch gives symptoms of inflammation of the arteries which are not found in clinical tuberculosis.

Animals inoculated with progressive doses of _Avian tuberculin_, or with serum of tuberculous animals, undergo wasting and loss of appet.i.te, and other general symptoms. They may die of cachexia, or may develop an isolated abscess; but they do not present characteristic symptoms as they would under the action of _Cantharis_, of _Phosphorus_, or of _Lead_.

Finally, inoculation with dead bacilli may produce real tuberculosis.

In the pathogenesy put forth by h.o.m.oeopathists, pulmonary symptoms do not occupy a prominent place. Dr. Burnett, who has experimented on himself with _Bacillinum_, notes at the end of his symptoms, after the headache, a slight and almost insignificant cough.

In explaining the clinical forms of infectious complaints, we are frequently forced to admit the increasingly preponderant part played by a.s.sociation of microbes--as it is the frequent case in diphtheria--and especially the modifications which depend directly on the disposition of the organ attacked, and not upon the action of the microbe itself.

An examination of the above considerations leads me to the following conclusions:

1. That the importance of the materia medica of the tubercular virtues ought not to be exaggerated. There are few characteristic symptoms to take off; it is more wise to guide oneself in the h.o.m.oeopathic application of the therapeutics by the clinical symptoms of the evolution of the various tuberculosis, rather than by the intoxication produced by their active products, the _Tuberculins_.