As but little has as yet been published regarding this remedy, except the provings, the experience of those who have used it will not only be of interest but also serve to introduce to the profession a truly valuable remedy, which from a want of clinical facts has not received the attention it merits.

No proving has been published with as great accuracy as that of this remedy. The names of the provers, the potency used and the time of taking the remedy have all been so carefully noted that any one can see at a glance what provings he can rely on. Those who believe only in the massive doses can observe the symptoms produced by the tincture and low dilutions while others who look for characteristic symptoms, can observe the effects of the potencies.

The names of the provers attached to the symptoms, especially when they are confirmed by several provers, are a sufficient guarrantee of their reliability.

There are yet several cough symptoms for which the remedy has proved curative, which have not been observed by many provers as pathogenetic of the remedy. Most of the other symptoms have been confirmed by clinical experience.

Dr. Carroll Dunham, to whom we are indebted for the suggestion to publish these observations, furnishes the following as his experience.

My clinical experience of the last two years has given me a feeling of great gratitude to Dr. Joslin, for his introduction of Rumex Crispus to the profession by his excellent proving. The value of the published proving is much enhanced by the publication of the daily records of each prover, which enable the student to appreciate the consecutive action of the drug much more perfectly than the Hahnemannian scheme allows, while the latter, again, is indispensable to the prescriber.

I have used Rumex chiefly in acute catarrhal affections of the larynx, trachea and bronchi. In these cases it seems to to me to present a close analogy in its action, to Belladonna, Lachesis, Phosphorus and Causticum. Without assuming to present an exhaustive analysis of the action of Rumex on the Respiratory organs, I proceed to state the indications for its use to which my studies of it thus far have led me.

Rumex diminishes the secretions, and at the same time exalts in a very marked manner the sensibility of the mucous membrane of the larynx and trachea, exceeding in the extent of this exaltation any remedy known to us. The cough therefore is frequent and continuous to an extent quite out of proportion to the degree of organic affection of the mucous membrane. It is dry, occurs in long paroxysms, or, under certain circumstances, is almost uninterrupted. It is induced or greatly aggravated by any irregularity of respiration such as an inspiration a little deeper or more rapid than usual, by the inspiration of air a little colder than that previously inhaled, by irregularity of respiration and irregular motion of the larynx and trachea such as are involved in the act of speech and by external pressure upon the trachea, in the region of the supra sternal fossa. These phenomena show a very great morbid irritability of the mucous membrane of the larynx and trachea.

The subjective symptoms are rawness and soreness in the trachea, extending a short distance below the supra sternal fossa and laterally into the bronchi, chiefly the left; and tickling in the supra sternal fossa and behind the sternum provoking the cough; this tickling is very annoying and very persistent and is often but momentarily and sometimes only partially relieved by coughing. The cough occurs chiefly, or is much worse, in the evening after retiring and at that time the membrane of the trachea is particularly sensitive to cold air and to any irregularity in the flow of air over its surface, so that the patient often covers the head with the bed clothes to avoid the cold air of the apartment and refuses to speak or even to listen to conversation, lest his attention should be withdrawn from the supervision of his respiratory acts, which he performs with the most careful uniformity and deliberation — and all in the hope of preventing the distressing tickling and the harassing cough which would ensue from a neglect of these precautions. I have frequently witnessed this state of things during the last three years and have invariably given prompt relief with Rumex.

In the group of remedies in which I have placed Rumex, (along with Bell. Lach. Phos. Caust.) it stands pre-eminent in respect to the extreme sensibility of the tracheal mucous membrane. All of these remedies produce symptoms identical in kind. The characteristic of each is to be found in the relative degree in which each symptom is pronounced in the different remedies, quite as much as in the possession by any one of them of symptoms not produced by the others.

Thus Belladonna, Lachesis and Rumex, produce each, a dry cough, induced by tickling in the larynx or trachea and provoked by deep inspiration, by speaking, and by external pressure on the larynx or trachea. Each produces soreness or rawness of the larynx or trachea. The cough of each is spasmodic and long continued and is worse at night after retiring. But, apart from the fact that Belladonna and Lachesis act more upon the larynx and Rumex more upon the lower part of the trachea, we observe that, in the case of Lachesis, the slightest external pressure on the larynx or trachea produces violent and long continued spasmodic cough; the patient cannot endure the least constriction in that region, not even the ordinary contact of his clothing. There is moreover a sense of fullness in the trachea and a very painful aching in the whole extent of the os hyoides. In the case of Belladonna not only is cough produced to a moderate extent by pressing upon the larynx, but soreness and pain are experienced with a sense of internal fulness and soreness which at once suggest the presence of Acute Laryngitis Submucosa. In Rumex, on the other hand, there is no sensibility, strictly speaking, of the trachea, but simply such an irritability of the mucous membrane that cough is produced by the change of position induced in that membrane by external pressure on the trachea. As regards the extent and intensity of this symptom, Rumex holds a lower rank than the other remedies named.

But the irritability of mucous membrane by virtue of which cough is induced by hurried or deep inspiration or by speaking, while it is common to Bell, Lach, Rumex and Phosphorus, is produced in the most exalted degree, as we have already seen, by Rumex, which, as regards this symptom, takes first rank. A sensation of rawness or roughness in the larynx, trachea and bronchi is produced by each of the four remedies above named, but the locality and the degree in which it is produced, vary in such a manner as to serve in some measure as a characteristic of each. It is most marked in Phosphorus and Belladonna, less prominent in Rumex, and least of all in Lachesis. In Belladonna and Lachesis it is most marked in the Larynx; indeed it is almost confined to that region. Rumex produces it in the trachea and upper part of the bronchi, while Phosphorus induces it in the whole mucous tract from the larynx to the smaller bronchi and moreover in the Phosphorus proving this “rawness” of the air passages is accompanied by a no less characteristic sense of weight and constriction across the upper part of the thorax, which indicates an affection of the finer air tubes and of the air vesicles of such a character as seriously to impede the function of respiration. In considering this last symptom we must mention Causticum also, which produces “rawness” extending the whole length of the sternum.

All five remedies, again, produce hoarseness; Phosphorus Causticum and Belladonna most eminently; Rumex less decidedly and Lachesis in a still less degree. As regards complications, Belladonna and Lachesis apply especially to those which involve the fauces and pharynx, and are acute, the one of a sthenic, the other of an asthenic character; Phosphorus to those of the pulmonary tissues of a definite inflammatory character and Rumex to certain affections of the lungs and their envelopes of which the nature is not clearly defined in the proving. They are indicated by pains, generally subacute, in the upper part of the lung near the clavicle and axilla, and more frequent in the left than in the right lung.

In addition to these observations on the Respiratory Organs, I have noticed, in one case, the cessation of a brown watery diarrhea after the administration of Rumex. A boy of 5 years, had brown watery diarrhea, chiefly in the morning, having five stools from five to nine a.m., attended with moderate griping pain in the lower part of the abdomen. This continued several days, notwithstanding two prescriptions which I made for it. Observing that the boy had a cough which presented the characteristic features of the Rumex cough, I gave that remedy, and both diarrhea and cough were speedily cured. The symptom, “brown watery diarrhea” occurs once in the provings. In relating this case I cannot forbear remarking that had I been more careful to collect and consider the totality of the symptoms, embracing cough as well as diarrhea, I should have given Rumex at first, instead of making two blundering prescriptions on the basis of a partial view of the symptoms which embraced the diarrhea alone.

The following case from my clinical record will illustrate the character of the Rumex cough.

M., aged 22, of feeble constitution, strumous, subject, for several years to subacute rheumatism — has had a severe cold for several days, and is now confined to the bed. The pulse is quick, not hard, 110, skin moderately hot and dry, face somewhat flushed. Respiration embarrassed not so much by any constriction of the chest as by the violent and long continued cough, which follows any attempt to make a full inspiration. A physical examination of the chest reveals no abnormal condition. The patient complains of roughness and soreness in the lower part of the trachea and behind the upper third of the sternum much more perceptible when she coughs. The cough is dry, slightly hoarse, very violent and fatiguing to the patient. It is provoked by a tickling in the supra sternal fossa — is induced by pressure upon the trachea in that region, and especially by talking and by deep inspiration or by the inspiration of cool air. This irritability of the trachea increases very markedly after 7 p.m., so that the patient suffers exceedingly from the constant tickling and violent cough. She can prevent them only by respiring with very great caution and deliberation, by avoiding all distractions of speech and conversation, and finally she draws the bed clothes over the head in order to avoid inhaling the cool air of the chamber.

This patient states that she has frequently had such coughs as this, and they have proved very obstinate although under skilful homoeopathic treatment. I gave Rumex¹² in solution a teaspoonful every two hours. After the second dose there was complete relief. The next evening, a very slight disposition to cough. No further symptoms.

I supplied the patient with Rumex³⁰, and advised her to use it at once on the occurrence of such a cough, and I am informed that she has always succeeded in subduing the cough within twelve hours.

The following cases in the practice of Dr. P. P. Wells, of Brooklyn, were communicated in a letter to Dr. Joslin, some years since. We regret that these are the only cases of Dr. W.'s, that we can at present report, but hope at some future time we shall be able to publish more, as the doctor's experience with this remedy has been very satisfactory.

Mrs. — , had been subject to eight miscarriages, all in the early stage of pregnancy, which in each case was early attended with dry, shaking, spasmodic cough, in paroxysm of great violence, which was regarded by herself and friends as instrumental in producing the abortions. At the beginning of the ninth pregnancy she came to Brooklyn to be under homoeopathic treatment. She had her cough, which was very dry, harsh, loud, shaking, worse at night, preventing sleep, excited instantly and violently by pressure on the trachea. The cough was relieved promptly by Rumex crispus,³⁰.

The following marked and rather important group of symptoms were relieved promptly, in the treatment of the case of our friend D., by Rumex crisp. ²⁰⁰, Lehrman's preparation. Thinking a knowledge of the fact might interest you, to whom we are indebted for our knowledge of this interesting drug, I send it. The cough begins with tickling behind the top of the sternum, and sometimes in paroxysms of five to ten minutes duration. Trachea sore to outward pressure, feels excoriated through its whole extent, as do also the whole fauces, cough excited by pressure on throat pit — cough is violent, with scanty, difficult expectoration, shocks the head and chest, as if the head would fly in pieces, and he feels as if he might raise blood any minute. He is greatly exhausted after the paroxysms of coughing; headaches during the cough. You have the group above in the order as written down for me by his brother, and upon which I prescribed the medicine, which was followed by the happiest results.

Dr. M. J. Rhees of Mount Holly, N. J., one of the original provers of the remedy furnishes the following:

Joseph H., aged 13 years. Subject to violent attacks of Inflammatory Rheumatism. In the spring of 18581 attended him in a severe attack in which the disease concentrated itself on the heart with so much violence that I almost despaired of his recovery. Pulsatilla cured the disease at that time. In December, 1858, he was again attacked, but the heart was the principal seat of the disease from the first.

On the 24th of December, his symptoms were, violent palpitation of the heart with throbbing of the carotids and throughout the body, visible to the eye and shaking the bed. Poise 120, violent aching pain in the region of the heart-Great dyspnea especially while lying so that it was necessary to prop him up in a sitting posture in bed. Face red and somewhat puffed up, especially about the eyes, which were red, heavy and lustreless. Tongue coated with white fur, with red tip and edges. Excessive thirst. No appetite Bowels costive. I commenced the treatment by giving Acon.³, and Puls ³ alternatively. Some relief followed the administration of these remedies, but the improvement was slow. From Dec. 28th to Jan. 9th, 1859, various other remedies were used as they seemed to be indicated but without decided improvement on the whole. On the latter date the patient complained of a stinging pain in the region of the heart which was increased by lying down and by breathing deeply.

In my arranged proving of Rumex crisp. the following symptoms may be found.

“No. 41. Burning stinging pain in the whole of the left side of the chest; suddenly when taking a deep inspiration, while in the act of lying down in bed at night.” “No. 49. Burning stinging pain in the left chest near the heart; came on soon after lying down in bed at night.”

These symptoms were fresh in my memory, and I accordingly gave Rumex crispus⁶, in water two teaspoonfuls every three hours. Jan. 10th. Considerably relieved of the pain in the chest and otherwise improved. Continued Rumex Jan. 11th. The pain in the chest is almost removed. Rumex was continued several days after this with the effect of entirely relieving the pain in the chest; but the improvement in other respects ceasing, Rumex was discontinued, and other remedies substituted, Bell,³⁰ and Phos,³⁰ eventually cured the case, and there has been no return of the disease.

Case II. — Miss M. B — , aged about 25 years, clear white, very smooth skin, rather pale; hair, dark auburn; very fall round figure. She called on me, March 24th, and complained as follows: She has not been able to speak above a whisper for nearly three months, and feels a soreness in the throat which is worse during empty deglutition, but is not increased by swallowing food. On examination, I found the posterior surface of the pharynx irritated and in places excoriated, the edges of the soft palate and uvula were red and somewhat swollen, and were covered with an eruption of minute red pimples. She has a slight hacking cough which is produced by a tickling in the larynx and upper part of the trachea. In other respects she is quite well. She attributes her symptoms to having taken cold. As she lived at a considerable distance from me, I gave her two packages of medicines, one containing Carb. veg.⁴ and Caust.²⁰ to be taken three times a day, alternately, and the other Mercurius,30 three times a day. If the first package relieved her she was not to take the second.

April 3rd. Reports herself no better. She cannot speak above a whisper and the pharynx presents the same appearance. The eruption on the soft palate is more extensive and looks almost purple, the pimples being larger. Her cough is decidedly worse, being almost constant; it is much worse when she first lies down in bed and for half an hour afterwards, and then abates. She complains of a tickling at the root of the tongue, in addition to the tickling in the trachea, causing the cough. I gave her Hyos.³ dry, three times a day, and in another package three powders of Rhus tox.³⁰ Nos. 1, 2 and 3, and three powders of Rumex crisp.⁰ Nos. 4, 5 and 6, one powder to be mixed in a half tumbler of water each day in succession, and two teaspoonfuls to be taken every three hours until better.

April 15th. She experienced no relief from the first package and grew worse while she took Rhus tox. She began with Rumex on the 11th of April, and on the 12th, found herself improving in every respect. Today she can speak aloud, but is somewhat hoarse, and the voice is weak. Her cough is very much better and the pharynx looks almost natural. The eruption on the palate has almost disappeared, but there is still some redness on its edges. Continue Rumex crisp.⁶ as before.

I have generally found Hyos. very effectual in relieving such a cough especially when it is increased by lying down. But in this case it was useless.

By referring to Dr. Joslin's published proving of Rumex the following symptoms will be found. No. 27. Sensation of excoriation in the throat. No. 28. Sore feeling in the throat on swallowing, in the forenoon. No. 77. Cough excited by tickling or irritation behind the sternum. No. 78. Cough excited by irritation in the chest. No. 80. Sudden change of voice at the same hour on consecutive days, the first and second of the proving; it became suddenly hoarse at eleven o'clock at night, &c. I was led to use Rumex by reading Dr. Joslin's report of several cases of cough cured by it. It will be observed that prominent symptoms in all those cases was a tickling behind the sternum. I think it is right to refer the relief of the eruption on the palate as well as the recovery of the voice in the above case to Rumex, and if so, these two symptoms will be a valuable addition to the pathogenesis of Rumex, and will enable us to combat more successfully a very troublesome affliction of the larynx, which has sometimes proved very obstinate in my experience.

Dr. B. F. Joslin, to whom we are indebted for the proving of this drug furnishes us the following. The cases of cough were treated with the 30th dilution of Rumex, and reported some years since, we believe in the Philadelphia Journal of Homoeopathy.

The following cases may awaken an interest in the pathogenesis, and stimulate others in its extension. I do not consider these or any other clinical cases an adequate guide in practice. The following symptoms are those contained in the brief records made at the time; others may have influenced in the selection of this remedy. For none of the cases was any medicine given after the Rumex. Where previous prescriptions had been made, they are stated, as far back as is requisite to enable the reader to judge, whether, and in what degree, they may have contributed either to the development or removal of the recorded symptoms for which the Rumex was prescribed.

Case I. — Mrs. B. had a dry cough, excited by tickling in the throat-pit, and attended with a sensation of excoriation in the larynx and in the chest behind the upper part of the sternum. The cough worse on walking. Pains in the chest. Took (Dec. 22d, 1850) Rumex crispus³⁰ in solution, at noon and in the evening. The third dose, the last, was taken next morning. In the evening of the day on which the medicine was commenced, and during the night, there was a severe and fluent coryza.

Next day (23d) there was a great mitigation of the tickling in the throat-pit, and of the cough which was much less frequent and more loose and unattended with excoriation in the larynx or chest. The patient stated that the last medicine, the Rumex, had done her much good. Lachesis had been given on the morning of the previous day. The cough was rapidly cured without the repetition of the Rumex, or any other medicine. The patient, previously to the taking of the Rumex, had cough for several weeks. On the the 15th, had taken Cham.³⁰, which immediately removed neuralgia of the face; on the 18th, Sulph.³⁰ for cough, with excoriation in the throat and chest; on the 19th, the same; and on the 20th, Calc. ²⁰

Case II. — Mr. C, had a severe fluent coryza with cough excited by tickling in the throat-pit. Sensation of excoriation behind the upper part of the sternum on coughing.

Took (December 24th, 1850) Rumex,³⁰ to be continued, morning and evening, for three days, if necessary. Cured promptly. No medicine had been taken for the cough previously — none was subsequently required.

Case III. — Miss W., a young lady of highly nervous temperament, had confusion of head; hoarseness in evenings; cough; excoriation behind the whole of the sternum on coughing and on inspiration; coldness of the fingers.

Took Rumex,²⁰ three times a day, commencing December 24th, 1850. Within a few days, the cough and excoriation were removed, and the patient was less nervous. The Rumex was the first and only medicine taken from the commencement of the cough till its cessation. The last previous prescription had been one dose of Pulsatilla,²⁰⁰ for neuralgic pain in one eye, which it immediately removed.

Case IV. — Mr. C, had a severe, dry cough, excited by an irritative pressure in the throat-pit, and attended with a sensation of excoriation in the larynx and chest.

Rumex crispus ²⁰ was administered December 27th, 1850, and directed to be taken in solution, morning and evening, for half a week. All the symptoms were removed without any other prescription, and none had been given for a long time previous.

Case V. — On the 21st of December, 1851, Mr. S. S., took one dose of Lachesis²⁰ dry, in the evening, for a severe cough. In the forenoon of the 22d it was found, on visiting him about 11 o'clock, that the cough had not been mitigated. He then took one dose of Rumex³⁰ dry, for the following symptoms, viz.; cough excited by pressing on the throat, and attended with excoriation in the larynx and chest, and with hoarseness. In the afternoon of the same day the cough was much better, and the patient slept several hours in the afternoon and early part of the evening, and had a general perspiration. The dose was repeated once in the evening, and once next morning. All the symptoms were removed within one day after commencing Rumex crispus.²⁰ The cough never returned, and the patient remained well. No other medicine was used previously or subsequently.

Case VI. — In January, 1852, during that remarkable depression of atmospheric temperature, (which usually occurs but once in fifteen, sixteen or seventeen years,) Mr. J., was attacked with a cough, which seemed to be originally produced by the inhalation of extremely cold air. The cough was violent daring the early part of several successive nights. The patient took one dose of Sulph.⁴⁰⁰ on the 21st, one of Ars.²⁰ on the night of the 23d, and one of Rumex crisp.³⁰ on the night of the 24th — all in a dry state.

January 24th. The cough returned with the same violence as before taking the Arsenicum. Cough worse when lying down — worst about 11 o'clock at night; excited by a tickling behind the sternum, and attended with a sprain-like aching near the sternum, and with accumulation of mucus in the fauces, near the posterior orifices of the nares. The one dose of Rumex³⁰ above mentioned removed the paroxysm in a few minutes, and it did not return. On the next day there was aching pain in the left shoulder, and fluent coryza with sneezing. These soon subsided without medication, and the patient remained well.

The following cases have not been previously published: Case VII. — On the morning of the 28th of November, a young lady, complained of shootings from the pit of the stomach into the chest in various directions, sharp pains in the left chest, dull aching in the forehead, and slight nausea. Ordered her to take Rumex,³⁰ morning and evening. She called the next day. All her symptoms had been removed by a single dose, and her appetite, which had been defective improved. Having eaten an unusually full dinner, there is a partial return of the shootings. 3 Rumex³⁰, e. and m., pulv. There was no further complaint. All the above symptoms are pathogenetic of Rumex crispus.

Case VIII. — A lady about 50 years of age, who had suffered about three weeks, with pain in the pit of the stomach, aching in the left chest, flatulence, eructations, pressure and distension in the stomach after meals — was permanently cured of these dyspeptic symptoms in two or three hours, by one dose of Rumex,²⁰⁰ March 1st, 1859. These symptoms are all effects on healthy provers.

Case IX. — A young lady has a sensation of fulness and pressure at the pit of the stomach, extending up towards, and to, the throat, and afterwards carried down again to the stomach when she swallows, and then rising again to the throat. This curious alternation has been observed in the proving of Rumex. Cured by Rumex,²⁰⁰ March 13th, 1859.

Case X. — A gentleman not accustomed to the use of tea, took a cup of it, very weak, and of the black kind, July 14th, 1858. There followed, aching in the pit of the stomach and aching and shootings above it in the chest, at, and especially on each side of, the lower end of the sternum. These symptoms were removed in a few minutes by one dose, a few dry pellets of Rumex.³⁰ These are some of the effects producible both by tea and Rumex, which is one of its antidotes.

Case XI — A lady about the turn of life, had diarrhea in the morning, four evacuations, between six and ten, a.m., feces very thin, evacuations painless; nausea on movement in the night preceding the evacuation; mouth dry; tongue slightly coated yellow. The day previous had dull pain on the right side of the sternum, sharp pain on the left. Gave Rumex³⁰ in solution, once in three hours; April 22, All the symptoms were removed. They were all such as Rumex has produced in the course of the provings.

Case XII. — Diarrhea in the morning with cough. — A lady about fifty years of age, has had diarrhea every morning for four days. The evacuations profuse, offensive and thin, and have even become watery, she is also suffering from a cough, excited by a sensation of tickling in the throat-pit; it is usually dry, but when expectoration takes place, this is tasteless: The cough shocks the stomach, and is attended with a sensation of excoriation in the chest. It keeps her awake at night. Rumex³⁰ 4th on the 30th of March, in the evening.

The cough was immediately and decidedly improved, so that she slept all night. Next morning she awoke with the most severe headache she had ever suffered; it was a continuous aching in the temples, forehead and eyebrows, and lasted all the forenoon. The cough and diarrhea were removed without any other medicine. All the above symptoms except the fetor of the feces, have been observed as pathogenetic of Rumex by provers.

Remark. — The cough symptoms have as yet been produced only by the attenuations. The strong counter-irritation of the tinctures on the stomach and intestines may be one cause of this deficiency. J.

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