By J. H. P. Frost, M.D., Bangor, ME.

May it not have been the case that those Homoeopathicians who have thrown doubt upon the efficacy of Lachesis, did not possess a reliable sample of this heroic remedy? Such has been the thought that passed through my mind as, again and again, I have seen the most prompt and beneficent action follow the exhibition of Lachesis in the most hopeless and desperate cases. When properly prepared as a homoeopathic remedy, its power for good is the exact analogue of the tremendous power for evil which it exerts in the natural state.

The forms of disease that best display the astonishing virtues of Lachesis, though various, are fortunately rare. But when they do appear, no other remedy can arrest the march of the destroyer. And in its far-reaching influence upon the deepest and most interior recesses of the human organism, no other drug, save Arsenic perhaps, can be compared with this. For it not only reaches the disease in the very penetralia of the system, but follows its course and completely removes it, even alter it has produced such structural changes as, in themselves, threaten to become reactively destructive. Its wonderful power in advanced stages of membranous croup, and the regenerating influence which it exerts upon gangrenous and dropsical conditions are examples to the point. Even Hempel [Materia Medica, Vo., II p. 541, Second Edition.] is forced to admit its efficacy in gangrene; but he has as little reason for limiting the sphere of Lachesis to “traumatic gangrene,” as he had for totally repudiating it in the first place. We give brief details of a case of each of the above-mentioned forms of disease, in which Lachesis was given alone and with the most gratifying results.

Case 1. About three o'clock of the second night I had spent in watching over a severe case of membranous croup, in a child of two years, I took advantage of some seeming abatement of the symptoms, to go home and get some sleep. Being summoned in haste, three hours after, I found the little boy in his cradle, recently awakened from sleep, apparently in a dying condition. This was not a simple paroxysmal aggravation of the case, but, after forty-eight hours struggle with the disease, the child seemed actually dying. I was just on the point of turning round to the parents and telling them so, and that I could do no more for him. But at the moment it occurred to me that they did not send for me for that purpose, but rather to try all in my power to save him. The desperate nature of the case and perhaps some peculiarity of the symptoms which I do not now recall and especially the remarkable aggravation after sleeping, led me to give Lachesis. And when I left the house half an hour after, so great had been the immediate improvement that I considered the patient out of danger. He took no other remedy, and made a speedy recovery. This was the termination of one of the severest and most obstinate cases of croup I ever fought out, one which began also in the middle of the afternoon. And I have ever noticed that the attacks of croup, which begin in the afternoon, are always of a graver character than those which first appear later in the evening; while those which occur after midnight seem milder still.

Case 2. A babe about a year old, and apparently healthy, had one or two incisors lanced. The little fellow proved to be what is popularly termed a “natural bleeder.” For five days and nights the blood flowed constantly, resisting every homoeopathic remedy, and external application. The flow, kept up in no small degree by his incessantly sucking the bleeding gums, continued till he vomited blood, passed only blood per anum and refused all nourishment. At last the Per-chloride of Iron arrested the hemorrhage. But the child, being of a remarkably scrofulous constitution as indicated by the nature of the case, if by nothing else, became cachectic and dropsical.

The anasarca was very great. Black and blue spots, Ecchymoses, appeared all over him; the least touch or pressure would produce them; and it was exceedingly difficult to handle him on account of the excessive tenderness of his body; there was a well-marked aggravation after sleeping; and extreme deathly paleness of the face. To this condition the case had advanced, in spite of Sulphuric acid, Arsenic, China and other remedies. And still the child grew worse, and the vital powers so feeble, that all expected a speedy release of the little sufferer by death. Lachesis prescribed and administered by Dr. B. C. Woodbury, at that time studying with me, and under whose immediate care the case was (at a considerable distance in the country,) effected a complete cure, of which the child is now a sturdy witness.

It is greatly to be regretted that no examination of the urine was made in this case; as it is a matter of no small interest to decide that the dropsy which results from excessive loss of blood is attended by albuminous urine. Marshall Hall [Quoted by Marcy and Hunt, Il. 741] says of such cases “ I do not know whether the urine

be coagulable.” Nor have I been able to find in other works, any more positive testimony on this point. But from what may be termed dynamic reasons, as regards the condition of the blood itself, I am inclined to think that the very scanty urine, whether whitish or darker colored, of persons laboring under dropsy from loss of blood, will be found largely albuminous.

Case 3. On the second day of last June I was called to see a Mrs. F., aged about 20, two years married, and now six months advanced in her first pregnancy. A year previous she had been very ill with fever, under allopathic treatment; and ever since, she had suffered from pain in the small of the back, and difficult, scanty and painful urination. Now, her lower limbs were very much enlarged, the dropsical swelling was very obvious in the sacral region; the urine was very scanty whitish, and threw down a thick sediment. In spite of the remedies which I gave, seeing her twice only in the first week of my attendance, she grew rapidly worse, partly from going up stairs to sleep at night, and was soon entirely confined to her bed. The urine on being boiled became wholly solid, albuminous to the last degree. The vulvae became enormously distended, so that she could only lie on her back with her legs widely separated. From her feet to her waist, the edema was very great indeed; her body up to the mammae was as round as a barrel. The totality of the urine passed in twenty-four hours would not exceed two ounces. She had little or no cough, and both heart and lungs remained unaffected; the edema was excessive but there was no effusion. The pulse was about ninety.

Acupuncture relieved the vulvae; the flow was copious, rapidly saturating the cloths; but although the almost transparent enlargement of the parts was not reduced more than one fourth during several days, she was made more comfortable. But neither Arsenic, Digitalis, Mercurius nor Apis, nor in fact any remedy I could find indicated, had any effect to increase the quantity of urine or in the least retard the steady and rapid increase of the general dropsy. It seemed that paracentesis would be absolutely indispensable; and even with that I could anticipate little more than temporary relief. And the more especially since I learned that not only her mother but all her mother's sisters and even her maternal grandmother were much inclined to dropsy in general, and particularly when enceinte.

Anxiously desirous of avoiding the operation which, if but partially successful, would yield little relief, and which if it allowed the escape of much of the vast quantity of water accumulated in the abdomen alone, could hardly fail to be followed by fatal collapse, I determined to make one more trial, and gave her on the evening of the 17th, one half of a fresh infusion of Apis. The next morning I found she had passed a chamberful of urine. Directing the remainder of the infusion to be given in divided doses through the day, on the morning of the 20th, I found to my disappointment, that no very considerable amount of urine had been discharged, though the patient was easier. Part of a new infusion of Apis was at once given, and at three p. m., being called in great haste, I found her in the almost convulsive agonies of desperate labor. The peculiar conformation of the edematous vulvae rendering the passage of the head impossible, I perforated it with my pocket knife, and, within five minutes of entering the house, successfully delivered my patient of a fully developed child of seven months, which had evidently been dead several days. Before the delivery, it did not seem possible she could survive, so intense was the agony, more than a few moments; while the distress about the chest and the imminent danger of thoracic effusion called for the most prompt and effectual action.

The next day the patient was quite as comfortable as could be expected. But the dropsy, instead of beginning to diminish after the delivery, continued rapidly to increase. The vulvae still required the acupuncture. The feet and legs at first seemed to decrease in size; but on the 26th inst., I found the left leg very much more swollen and painful from the knee down; and she had dry, hacking cough. On the 27th, her pulse was 110; the swelling of the bowels had subsided as the left leg increased in size; and she complained of great pain from the least movement of the leg, and a steady ache in it all the time. The whole of the left side was now remarkably enlarged, and but little urine had passed since her delivery. She got Bryonia with no improvement, till the 29th, when she complained of pain in the bowels and head, and nausea and faintness on being raised up; the urine was almost totally suppressed, and she was evidently very low. On the 30th no better; the left side and leg still more heavy, the latter almost like elephantiasis and so enlarged that she was entirely unable to move it. Gave Lachesis⁸ a powder dry, once in four hours.

Calling the next day I was most agreeably surprised to find her better. She had passed six quarts of urine since taking the Lach. twenty-four hours ago; and she can move her leg a little. July 2nd, I continue to quote from my note-book, passed a great quantity of urine under Lachesis⁸ July 3rd. Much better; the swelling is going down from the left side and leg; passes a great deal of water. Lach. ⁸ ter in die. July 4th. Still better; pulse ninety-six; Lach²⁰⁰

July 6th. Much better; medicine continued. On the 9th, I gave Lach. ⁸ with benefit. On the 13th, for pain in calf of the leg worse on motion, she got Bry. On the 15th, she complained of feeling faint, “all gone” after eating; pains in the left knee, with considerable contraction of the cords; gave Kalm. lat. under which she improved. I find no further notes of his case till the 29th. “Still some swelling in the legs; but she is down stairs, goes up to sleep, and has been out of doors.” Lachesis⁸, a dose once in a day or two, for a little while, removed all the last traces of her illness.

Thus the Lachesis (with the doubtful help of one or two intercurrent remedies) in a remarkably short time restored to perfect health a young woman constitutionally predisposed to dropsy, whose kidneys had been diseased for an entire year, and in whom the dropsy and albuminous urine incident to pregnancy had very greatly increased after her premature delivery. Her health and strength are now, after six months, better than they had been for a year and a half previous; she keeps house and does her own work. The most strongly pronounced indications for this remedy in this case are found in the remarkable swelling of the left foot and leg, and the swelling of the whole of the left side. Great paleness of the face was also a marked feature in this case.

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