of the malady. Thus in one patient every symptom had entirely disappeared in ten days, while in another robust man the cure was only effected at the expiration of fourteen weeks. Pleurisy attended with the greatest fever follows generally the shortest course, while on the contrary, when arising gradually or slowly, it disappears but slowly. The age likewise, and the temperament of the patient, with a number of other but partially known causes, exercise a great influence on the duration of the disease. Hence, although it is scarcely possible strictly to state a general result, there yet remains that of individual cases. We may certainly not be able to maintain that many cures of pleuritic effusions are effected by art, but we can nevertheless venture to assert, that many cases are undoubtedly accelerated by art, and we only regret that this is not the place where, by entering into details, we should be able to prove the justness of our observations.

Sulphur was here, likewise, the remedy most frequently used; it was given twenty-five times alone, and six times before or after other medicines. As in pneumonia, so also in pleuritic effusions, which followed a simple course without originating in any particular dyscrasy, sulphur seems to us to be well adapted for the removal of the effusion. When the disease was unaccompanied with any considerable febrile action, we prescribed sulphur from the commencement, otherwise, immediately after the removal of the fever. The latter we treated with Bryonia, especially when there were violent shooting pains in the chest, more rarely with Aconite. In weakly, cachectic looking individuals, with probable breaking up of the exudation and long standing effusion, with approaching debility, we found in Arsenicum a remedy which cannot be sufficiently lauded, to which we attribute the cure of a case which to all appearance was hopeless, as well as of some other very severe maladies. Besides these four remedies Lobelia was used twice and Spigelia once, without any result.

VOL. XIV, NO. LV.-JANUARY, 1856.

SEPIA.

BY DR. V. MEYER.

(From the Homœopathische Vierteljahrschrift, 4ter Jahrgang, 2 Heft.)

(Continued from p. 654, vol. xiii.)

The impediments to the circulation originating in the portal system must gradually be transmitted from one organ to another, as we here observe to be the case in the affection of the stomach and intestinal canal. The impeded reflux in these central organs of reproduction must necessarily give rise to important disturbances in the process of digestion; it is undeniable that these disorders must be greatly increased by the reflex action which such a state of congestion of the mucous membranes must exercise on the nerves in immediate proximity with these organs. Sepia unfolds, as has just been remarked, a large number of symptoms, which are principally seated in the stomach and colon. In the first place we will remark that the tongue, which is considered by both the laity and the profession as a sure criterion of the state of digestion, is covered with a white slimy coating, accompanied with a bad odour of the mouth and variously disordered taste, loss of appetite, aversion especially to meat, nausea, particularly in the morning and after eating. Various disordered conditions arise after a meal; a very annoying weight and fulness in stomach and abdomen, congestions of the head and chest, with supervention of rheumatic pains. Attacks of cardialgia are well defined; the pains are principally drawing, pressing, scraping, shooting and external, at times even to the back; the epigastrium is sensitive to pressure; pyrosis, a sign of an abnormal intermixture of the secretions of the stomach, is likewise readily induced. There are even a few symptoms which indicate a perforating ulcer, either caused by a chronic catarrhal condition of the stomach, or what is still more probable, by a certain acridity of the secretions. The following are the symptoms:

A severe pain at the cardiac orifice of the stomach on swallowing

food. Painful eructation; blood comes up into the mouth (after fast riding.) Eructation of blood in a very warm room.

The following symptoms we consider as an indication of the pulsatio abdominalis:

A beating in the scrobiculus cordis while eating, becoming greater according to quantity taken.

The hiccough induced by Sepia is dependent on irritation of the vagus by the hyperæmic condition of the stomach causing spasmodic action of the diaphragm. Hence hiccough is a very frequent accompaniment of catarrh of the stomach, and especially of the weakened stomach.

A large portion of the symptoms arising from disordered digestion are owing to flatulency, which are so abundantly produced by our medicine. The most frequent cause of the abnormal evolution of gas in the intestinal canal is attributable to a paralysed condition (atony or torpidity) of the tractus intestinorum, in which case on the one hand there is an enfeebled action of the muscular coat of the bowel, and on the other an abundant mixture of the gastric secretions. A greater variety of painful sensations are caused in the various organs already mentioned according to the greater necessity for the evacuation of the accumulated flatus either by the mouth or anus, and the facility with which this takes place. Hence we find among the symptoms of Sepia,-pressure in the scrobiculus cordis, with yawning and rumbling-(borborygmi caused by air moving either in the stomach or intestinal fluids)-frequent eructation, abdominal distention after eating, with alleviation by discharge of flatus, colicky pains. The stool is partly costive, partly fluid, as is frequently found in similar abdominal affections; various symptoms occur before and during the stool. The urine deposits earthy sediments, a frequent symptom in gastric disorders.

If the whole of these symptoms arising from disordered digestion are considered as an evident proof of the sphere of action which we have assigned to Sepia, it will be found that the following symptoms will still further corroborate such an opinion.

3. HÆMORRHOIDAL AFFECTIONS.

Pain in the rectum during stool and afterwards for a long time

Cutting in the rectum.

while sitting. A contractive pain in the rectum extending to the vagina. Cramp-like pain in the rectum. Stitches in the anus. Burning in the anus.

Discharge of blood during stool.

Itching in the rectum and anus. Three liquid acrid stools in the day, followed by protusion of varices, which are very painful when sitting. Protusion and itching of internal varices. Soreness in the rectum, mostly between stools, and a pressing outwards even when lying down, in paroxysms every hour, with varices of the anus which are sore on being touched. Great protusion of internal piles when walking. Great protusion of internal piles while at stool. The external piles are painful. The external piles appear to be indurated. An attack of a pressing drawing pain in the umbilical region, followed by a mucous discharge from the anus with tenesmus and shooting; soon after congestion of blood in the chest, with anxiety and uneasiness, which after dinner passed into a sort of fever; internal heat alternating with shivering, and sweating of the head from 1 to 4 o'clock, then headache which left behind a pain in the neck; the following day a recurrence of the same attack. Great desire to go to stool, with only a discharge of flatus and mucus, and a sensation of a plug in the rectum. A hard and difficult evacuation although mixed with mucus. A discharge of blood without a firm stool. Blood at each stool for eight days. Much blood during stool, preceded by cutting in the abdomen. Some blood daily during stool for a long time. Bleeding of external piles when walking. Itching inflammation in the penis, causing a great desire for an embrace. Heat and itching of the glans penis, with soreness of the prepuce. Heat of the glans, with a pale red and at times itching eruption. Red points on the glans penis. Great moisture under and on the glans, a puriform fluid of a sour saltish odour, with itching. The prepuce matters and itches constantly. Red and almost sore papulæ appearing and disappearing on the inner portion of the prepuce and on the glans, with a ticklish sensation on being touched. Itching of the pudenda. Soreness and redness of the labia, of the perineum, and posteriorly between the thighs. Violent stitches in the pudenda. Blood-red urine. The urine deposits blood in the vessel. Pressure on the bladder and frequent passing of urine, with tension in hypogastrium. Constant urging to urinate with painful pressing in the pelvis early in the morning. Frequent and very urgent desire to urinate. Great desire to urinate in the evening, with burning afterwards. After heat, redness and puffiness of the face for two hours,

soon followed by fulness and inability to urinate for fourteen hours, which was succeeded by urgent desire to pass urine every quarter of an hour, with but a scanty discharge; many similar periods of stoppage of urine and urgency to urinate occurred, on the last of which occasions the retention of urine lasted for twenty hours, notwithstanding the quantity of fluid taken. He was obliged to pass water two or three times in an hour; there was pressure of the bladder, still he was obliged to stand a long time before he could pass urine, which he at length did without pain; when attempting to stop he is seized with agony, and pressure on the bladder. Pressure to urinate early in the morning, and urgent desire to pass water, in which he only succeeds after some minutes.

It is too well known that hemorrhoidal affections are the most frequent consequences of obstructions in the portal system, to need any further discussion. The Sepia symptoms which have been above mentioned are concise delineations of the disease,itching, shootings, burning in anus, varices, and discharge of blood and mucus. We likewise find in the female provers the intertrigo hæmorrhoidalis in the perineum which so often accompanies hemorrhoids, and in males the eruption and increased mucous secretion of the glans penis. Congestion of the mucous membrane of the bladder is often the cause of blood appearing in the urine. Not unfrequently a species of spasm of the bladder is caused by this condition of the mucous membrane, as well indicated in the symptoms above detailed. Although I am willing to allow that this affection may be sometimes cured by Sepia, although there may not be any perceptible congested condition of the mucous membrane, the existence of spasm being the only symptom of the malady indicating the use of our remedy, nevertheless it seemed to me better to mention this symptom here.

We will next pass to the consideration of those affections of mucous membranes which so frequently result from stagnation in the venous system.

4. CATARRH.

(a.) Catarrh of the inner portion of the mouth.

The internal portion of lower lip as if sore, and covered with numerous painful blisters. Swelling of the mucous membrane of the