BY CONSTANTINE HERING, M.D., PHILADELPHIA.

Introduction. — Many friends of our cause, when it was proposed to prove Lithium, objected that it was too rare a substance; that the hunting after rarities divides and exhausts our forces. To this, the following may be said in reply:

Suppose it were proved that widely diffused substances have a widely diffused application and so in proportion — that, accordingly, weeds belong to the most important drugs, it would still be important to acquire a knowledge of the rarer substances,

1. Purely for the sake of science,

2. With a view to the treatment of the less common diseases, which present themselves the more frequently to us Homoeopathists, and by the curing of which our reputation is established or maintained,

3. Because, in truth, we do not yet know very much about the origin and diffusion of substances.

But, in fact, the above proposition is by no means proven. True, Silex is one of the most widely diffused substances. And Silicea is a Polychrest; we administer it in very manifold diseases and could not get along without it. Common salt, lime, carbon might be cited as other examples and the conclusion drawn; widely diffused remedial agents correspond to widely diversified diseases! But yet this would be false! “We must admit the correctness of an altogether different conclusion. It is true that Silex is found in the greatest abundance in the crust of the globe — more so than any other earth. It is also present in plants and necessarily so, although in relatively less quantities and yet as it appears, more important. It is found also in the human body, but in a. still smaller relative quantity.

Now since Silicea can unquestionably induce, in the smallest doses, the most remarkable changes in the human organism, can effect the most important cures, may we not rather draw another conclusion, viz.: constituents of the body, though smallest as regards quantity, produce the greatest effect. Perhaps the facts are to be regarded inversely and Silicea is so important a remedy, not because it predominates in the crust of the globe, but because it exists, in the smallest quantity, in the human body.

Hahnemann has demonstrated that effect and quantity are not proportional to each other; from this many sequences follow. Those who cling to quantity may make as long faces as they please * * that does not alter the matter. Every substance which is contained in the body as a constant constituent, is necessary; it has therefore a constant, necessary function, although our Physiology, still in its infancy, may not yet enable us to recognize it. This function must be so: much the more important, the smaller the quantity of the substance. Substances of this kind, probably exist in the body in the same condition of attenuation (“Spauning”) as that into which our remedies are brought and which Hahnemann called potency (“Potenz”). They develop the activity discovered by Hahnemann, and which, though analogous to chemical action, is yet a higher, a more important, a conditioning and withal a physiological action. If the same substances in the same condition, be laid upon the balance of the living organism, they disturb, throughout, the whole body, the functions of this substance, i. e., they give rise to symptoms.

If they be placed upon the balance in appropriate cases of illness, where the similarity, i. e., likeness and contrariety, is conditioned by illness, they cure.

This conjecture has grown out of a great multitude of experiments on myself and others, on animals and plants; that is to say, many definite experiments led to the above explanations as their probable basis.

It may certainly be objected, that it is questionable whether the experiments were properly made, and still more questionable whether the conclusions were justifiable; it is possible, I know it right well, that in many respects this may be so. Well! he who ten years ago, was in pursuit of errors, which he subsequently recognized to be such, may today, be again pursuing other errors, of which it may, perhaps, take him ten years more to free himself!

Inasmuch however as nothing complete and definite can yet be printed touching the above premises, I purpose here merely to say, in reply to lazy opponents, who imagine that these investigations have been made with a laziness corresponding to their own, that my statements are not premature and that they are the result of much labor and painstaking.

But is Lithium contained in the human body! We know not. Will it prove to be a good remedy! We do not know. But we must acquire a knowledge of it, as a remedy, if it were only for the sake of comparison. If we mean to have a science, we must possess the means of comparing among themselves the groups of nearly related substances; we must learn to know that similarity by which they are characterized as a group, not merely through their chemical action upon other substances, but also through their action upon the living organism. Even when we in this way elaborate for example the salifiable Cyanogen, Chlorine, Bromine, Iodine and Fluorine, we are unable to determine anything definitely until we have, along side of this, another family for comparison with it. As yet only Ammonia, Kali, Natrum are known to us. If now we associate Lithium with these — the fifth alkali is as yet wanting (1843) — the first steps are taken.

But we derive also another motive and from the old school. Lipowitz discovered that the presence of Carbonate of Lithium renders uric acid much more soluble in water. Uric acid is sparingly soluble in water; perhaps it is more soluble in the blood through some influences not yet investigated. If influences of this kind do not diminish an overplus of the uric acid when such an excess has been produced by other derangements, then this Tartarus of Hohenheim is excreted and forms gout-stones gravel or vesical calculus. Carbonate of Lithium is less soluble in water than the similar salts of Natrum or Kali; one hundred parts of water dissolve only one part of Carbonate of Lithium. But this one part renders soluble four parts of Uric acid, whereas, otherwise, only one part of Uric acid is soluble in ten thousand parts of water. Its solubility therefore is increased four hundred fold, and one grain dissolves in a quantity of water which would otherwise have dissolved only 1/400 of a grain, and Lithium in this respect surpasses the other alkaline salts in the proportion eight to four, two and one (1. Bicarbonate of Soda; 2. Borate of Soda or Carbonate of Potassa; 4. Carbonate of Soda; 8. Carbonate of Lithium). There is an additional advantage, that this one part of the Carbonate of Lithium, dissolved in one hundred parts of water, has no such strongly corrosive properties as the other alkalies. Andrew Ure found that in such a solution at blood-heat, a vesical calculus was corroded and lost five grains in five hours; he therefore recommended injections of Lithium. (Gazette Medicate de Paris, February, 1844; Buchner's Repertorium, Bd. xxxiv, Heft. 2.)

This gives us only a further reason for investigation. All substances, which dissolve others or render them more soluble, must have for the latter a kind of affinity, or relationship; they have, so to speak, a love for one another. These substances, as, for example, Lactic acid and Phosphate of Lime, etc., must have a similarity in their action and must support and complete each other in the cure of diseases.

Upon the principle, that the chemical action must be analogous to the dynamic action, we must bring into especial prominence these actions upon the Uric acid. Lithium must have, in its dynamic action, a similarity to those processes upon which the deposits of Uric acid depends. The phenomena, which are produced by Lithium, from a homoeopathic antithesis to the phenomena through which Uric acid in excess is produced.

While all these conjectures and hypotheses should serve only to clear the way for repeated experiments, Kirchoff has demonstrated that Lithium is a very widely diffused substance.

It is not merely contained, in a few varieties of Swedish mica, not alone in the granite of Penig in Saxony; not merely in the Carlsbad and Franzens-Brunnen waters, as Berzelius discovered, and in the Wein-Brunnen of Nassau as Kastner found, not alone in many other earth formations, our knowledge of which is every year increasing — but according to Kirchoff it is contained in every cigar — and, who knows where besides! Now if it should only by accident get into the human body it might yet through substitution, change the well known actions of Potassa and Soda. But the questions whether? and which? and how? can only be answered by a long series of experiments of which only a small beginning has here been made; incomplete and insufficient, it is true, but still very promising and already useful in many ways.

EXPERIMENTS WITH LITHIUM CARBONICUM FROM THE FACTORY OF SCHONBERG.

1. When making the trituration, pains in the eyes as if little grains of sand were in them; decidedly greater in the left eye. Later stitches in the right eye. C. l. r.

2. 1843, April 15th, 11:30, a.m. About a half grain of the third trituration taken while driving in a carriage — only chocolate taken in the morning; no stool — a damp, cool day.

In 5m. In the right inner canthus a cooling sensation, as if from salt.

In 6m. Pain inwardly above the globe of the eye — above the external canthus. Pain in the left side of the head, a sticking-burning sensation, going from below upwards — the same in the right malar bone.

In 10m.. The same sensation in the epigastrium. The head is painfully confused on both sides.

In 15m. The same pain internally at the left knee.

In 20m. The same sensation in the right lower molar teeth. Sensation as if the bladder were affected.

The above pain over the right eye outwardly, above the right knee and inwardly towards the patella.

12:00, m. Itching burning pain in a small spot, externally on the right hip, then on the thigh, then on the outside of the little toe. Pain on the anterior side of the right shoulder-joint, near the insertion of the Pectoralis major, at the margin of the muscle. A shudder runs over the anterior surface of the body, starting from the thorax, like a drawing together. (Other shudderings, subsequently, starting from other regions.) Dropping from the nose in open air; also, later, in the room. Twitching, drawing pain around the right eye, above, on the external side especially, and deep in the orbit. The middle finger of the left hand, which had been chafed about 10, a.m., is painful; a pain which goes from other parts towards the spot, precisely of the same character as the other Lithium pains.

The sunlight blinds him upon the streets, on a dull day. The knees pain on going up-stairs, but more the parts above the knees. Sensation in the throat as though it would become sore. Pain superiorly in the right calf, and which goes downwards. Violent pain horizontally in the hypogastrium, in the upper region of the bladder. Twitching pain through the right foot, beginning at the heel and extending towards the middle foot. Itching, sticking pain internally on the left thigh. Coryza (dropping). Headache, like a stitch, superiorly in the vertex on the right side, sensitive when touched, 1:30, p.m. Sudden violent tenesmus of the bladder; the dark yellowish urine is in much smaller quantity than usually follows such tenesmus, with him; seven ounces instead of nine, ten, and eleven ounces. (The next morning, the urine was turbid without deposit or cloud, such as had always accompanied this phenomena before.) Five minutes later a sensitiveness and pain in the middle of the urethra, a kind of pressure; yet without any tenesmus.

1:40, p.m. Sensitive pain in the region of the bladder, a sharp pressure, more on the right side, like a flatulent colic.

1:30, p.m. Pain in the region of the heart, twitching, like dull stitch, lasting from five to ten minutes.

2:00, p.m. Pain behind the left ear in the bone, extending somewhat towards the neck and farther.

The prover took a good dinner, without drinking wine or beer, but after dinner took coffee. Gentle twitching to and fro in the seminal cords and vesical region.

2:30, p.m. Coffee and cigars.

2:33, p.m. Pain along the middle finger towards the extremity, then in the left metacarpus in an outward direction, with burning stitches as if it would itch, especially is the ball of the thumb. The Lurning-sticking pain, in jerks from within outwards and ending in itching seems to the prover to be characteristic. Burning stitch in the ball of the left thumb. The left middle finger, in the spot that was chafed is very painful.

4:30, p.m. Twitching pains in all the fingers, especially in the second and third fingers of the left hand as if in or upon the bones, internally from the hand towards the extremities, throbbing, twitching, very sensitive during repose; but ceasing on pressure, on being grasped and on motion; first on the right side, then on the left.

In the evening pain in the metacarpal bone of the little finger of the left hand. Headache, superiorly, on the right side. Great weakness of the knees on going upstairs, this morning, but not at noon nor in the afternoon and evening. Evening, eight o'clock, when walking, a violently painful, dull stitch in front of the anus in the perineal region, from within outwards and from above downwards. Ten o'clock same in the sacrum. Pressure as if with a dull pain here and there internally as if near the bone; in the evening, most on the left side.

Tenesmus of the bladder and micturition in the evening between eight and nine o'clock in the street; before and for a short time after it, Lithium pains in the region of the neck of the bladder and other parts of the urinary organs. The same pain in the region of the neck of the bladder on the right side. The ankle joints pain when walking, first the right the more and then the left. Frequent urgent pains, of moderate severity, of a sticking character, from within out wards, ending in a burning itching, in a small spot, more on the left side.

From eight to nine o'clock sore-throat posteriorly on the right side, as if sore when swallowing.

9:45, p.m. Itching in the anus, very sharp, sudden and short. (He drank beer in the evening.)

Late in the evening, toothache in a left lower molar tooth. Slept during the night without further symptoms.

April 16th, a.m. Tenesmus of the bladder for awhile and then a discharge of clear frothy urine in a great quantity, thirteen ounces; more than he could retain so long when in health. On rising to pass water, pressure about the heart, which ceases only after urinating. Sore pain in the margin of the superior right eyelid, a feeling of dryness. The urine of the forenoon — two to three ounces — is peculiarly turbid and forms a scanty fluent deposit. Two o'clock after dinner, a hard stool, the first since day before yesterday. Before urinating, fugitive, sensitive pains in the lower region of the bladder, somewhat towards the right. After urinating, pains extending into the spermatic cords, more on the left side.

8:00, p.m. When sitting, Lithium-pain on the right side in the penis and at the root of the penis, throbbing stitches.

April 18th. In the morning diarrheic stools, immediately after chocolate. Later, a dark reddish brown urinary deposit. The prover has the so-called gouty diathesis, and at this time, had been for a long while free from his usual hemorrhoidal difficulties.

3. The same prover (C. Hering) took, November 7th, at ten, a.m., five drops of a 1/100 solution of Lithium causticum. Did not remark until after taking it, that it seemed to have attacked the walls of the containing bottle and had a scanty deposit at the bottom. The solution had stood three years. The deposit seemed to increase after opening the bottle. (The experiment may serve to compare with the others, for the caustic solution of Lithium unites with Carbonic acid even in the act of passing over the tongue and fauces.) Prover had had, for several weeks, a pain in the external lower part of the right scapula which this morning showed itself on the left side also.

12m. Headache on the right side superiorly, later on the left side.

12:15, p.m. Pains externally, first in the left shin, then in the left hand.

1:30, p.m. Painless, but unpleasant tensive pressure on a small spot in the neighborhood of the stomach, towards the right of, and below and behind the epigastrium. Slow belching eructations before dinner; then pain in the left parietal bone. Already before one o'clock, a paralytic stiffness in all the limbs and the whole body. Now and then, tooth-ache on the right side and posteriorly. Slight pains here and there, sometimes becoming more violent, most perceptible in a small spot in the right temple (for several days together). Passes less urine although he drinks as much as usual. Must blow the nose a great deal, in the evening, more mucus hangs behind (in the nares).

Evening, itching of the left middle finger near the nail and around on the left side of the finger.

Late in the evening intense itching, compelling to scratch until the part becomes raw, on the whole inner side of the right thigh and also on small spots in the adjacent parts.

November 8th. Memory for names less retentive than usual. Yesterday no stool — today, first hard, then soft and bright yellow (yesterday evening, he ate eggs in bread soup).

November 7th, 8th, 9th. Very many small penetrating-putrid smelling evacuations of flatus.

November 10th. For several days past a striking decrease of appetite. Neither desire for breakfast in the morning, nor during the day any desire to eat anything. On beginning to eat, the appetite is immediately satisfied; no desire for wine, beer, coffee or sugar.

At evening, he eats some herring; later when lying down has a violent cough without expectoration which compels him to sit up; the irritation, which provokes the cough, is in a small spot posteriorly and low in the throat. It consists of quick shocks, which do not seem to come out of the chest; not from low down; but they seem to be produced in the throat, only in short paroxysms, but very violent and exhausting; ceases gradually. For several days, when eating and drinking, all further desire ceases, yet without any aversion. For several weeks, on the borders of the nails, soreness, redness and pain only prevented from extending, by constantly loosening the fold of skin from the root of the nail. It is more at the external angle, first of the left thumb, then of the right fourth finger, then of several fingers of the left hand, then of the middle finger of the right hand. The skin adheres more firmly to the growing nail, which had also been observed before and since.

4. A young lady of twenty years, took Lithium carb.²⁰, evening and morning, on account of violent pains in the region of the heart, before and during menstruation. Menstruation ceased too soon and suddenly, and at the same time the pains in the heart ceased also. The next day, she had, on awaking in the morning, a violent headache in the vertex and temple. The third day, headache still continued. The fourth and fifth day it was less, but the sixth day very severe again in the left eye, in the temple and in a small spot in the occiput; on the seventh day very severe in the temple and vertex, and inasmuch as she thought vomiting might relieve her, she drank some warm water, but to no purpose. It is like a heavy weight upon the vertex and pressing in the temple; the whole head seemed too large and as if it were seized; the most violent pain is in small spots and this in particular increased the nausea. Could hardly keep the eyes open; they pained as if sore from morning till noon. When looking at any thing the head became worse; she cannot remain lying down, it pains everywhere; when sitting, somewhat better; relieved by going out,

5. A young man, R., who has been for several years tormented with a peculiar irritability of the bladder, a frequent, burdensome tenesmus, which rendered all business, society or traveling irksome to him, took for experiment Lithium carb.²⁰ from twenty to one hundred globules. The first day, the first dose was taken after the regular stool, after breakfast. An hour afterwards, a second stool, which was quite uncommon. In the evening, the second dose. At night, lustful dreams. On awaking, micturition, and after it a violent erection and lustful feeling, such as he never before had, for an hour; then he slept again. This night he waked two or three times again with erection, tenesmus vesicae and lascivious titillation in the urethra; and, on account of the erection, he could not pass water, When, however, he succeeded in doing so, the erection ceased entirely; therewith, pain in the bladder and scanty urine, about three wine-glass-fulls.

The second day, in the morning, he took nothing. Urinated more frequently and more copiously, and had after it the lustful titillation in the urethra. His customary bladder symptoms however did not appear. At noon he took the third dose.

2, p.m. A disposition to weep over his lonesome condition, so that he sobbed, the nose being full of water.

The whole afternoon, very frequent urination.

Evening, nine o'clock, the fourth dose. This night, again, lustful dreams. On awaking, tenesmus vesicae and erection, which ceased after urinating.

The third day, in the morning, the fifth dose. Urination.

Noon, the sixth dose. Afternoon better.

Evening, the seventh dose. The first three days he had an expectoration of mucus from the choausae and fauces, in thick masses, especially morning and forenoon; at noon the whole abdomen felt as if swollen, distended with wind.

From three, p.m., till ten in the evening, frequent discharge of very offensive flatus. The third day, in the morning, the urine was scanty, dark and very acrid; pain, on passing it, as when lye passes over an irritable surface; the evacuation of it is thereby rendered difficult. The fourth day the same; and the whole day, pain in the bladder. In the evening, sweat on the backs of the hands, while the palms are dry. Itching of the sole of the left foot on the inner margin, compelling to vigorous scratching. The offensive flatus continues. The fifth day, on going out after breakfast, a constriction of the chest, then, by hawking, an expectoration of mucus in great quantity, appearing to come from the middle of the sternum. The whole day, a restlessness in the renal region. Afternoon, again a pressure in the middle of the chest, pain in the bladder, frequent urination, yet all these less than formerly and all ceasing gradually.

After drinking water, unusual gulping up of water, and for a whole week diarrhea after fruit, which was also unusual, and for which he took Nux and Puls. This increased the quantity of urine and the sudden tenesmus vesicae. He took Rhus, whereupon the quantity diminished, but the irritation continued. He therefore again took Lithium carb.²⁰, one hundred globules, whereupon it ceased.

The following day, he took, in the evening, the second trituration in water. The next morning and the whole forenoon, the nose was obstructed, above in the nose and forehead; the bladder less irritable until three, p.m.; the acidity of the stomach ceased. The next day, he alternated globules of the thirtieth, and solution of the second trituration and continued them for several days, without noticing anything, except a very copious sweat He took on this account Lithium mur.; he had to go on a journey, and while on the road was seized with cholera, and subsequently with a cough, which indeed he did not connect with these circumstances, but which had already previously befallen him after many remedies take at random.

6. The same. Has had for several years a sore nose. The nose felt very much swollen and was really somewhat so, with a moderate redness, inwardly sore and sometimes forming thin crusts or scabs; everything was worse on the right side. The nose dry and as if inflamed; at the same time his former bladder symptoms; frequent urinating, especially at night.

After Lithium carb.²⁰, the nose became immediately moist and every sign of inflammation, redness and swelling, entirely disappeared. The frequent urination ceased, he slept undisturbed at night. The painful tenesmus of bladder had been also relieved by Argentum nitr., which, however, does not act upon the nose. If he had both troubles together he must take Lithium. As an entirely new symptom, he perceived after taking Lithium, fine twitching stitches through the pubis, passing from behind forwards and across — as fine as the smallest line, passing suddenly and like lightning hither and thither and repeated every time after taking it anew. It leaves an enduring pain after it After repeated doses he feels over and over as if beaten, stiff and sore in all bones, joints and muscles. He took for this in alternation Bryonia, which did not hinder the good action of the Lithium upon the other symptoms, until the general symptoms vanished.

7. A. Gk, a young lady took Lithium carb. first centesimal trituration, in water, in the evening. She had, the next morning, a headache in the left vertex, a kind of stitch. Before breakfast, a fullness in the pit of the stomach, she could not endure the pressure of her clothes upon the parts; pressure upon it with the hand would have made her vomit; she had never before felt So. In the afternoon on going out, violent pain in the region of the liver, between the crest of the ilium and the ribs (upon the extreme right) such as she had sometimes had previously; and in the left iliac bone a pain such as she had often had before.

8. The third trituration caused in G., a man 70 years of age, pain on the right side in the ureter and through the spermatic cord into the testicle, which however did not become sensitive to the touch; then, turbid urine with more mucous deposit; after which the urine became and continued clearer than for a long time.

Dr. Neidhard took half a small phial of a solution of the first centesimal, at nine, p.m.

10:15, p.m. Pressure in the region of the liver and a gentle pressing pain in the left forehead, and subsequently over the eyes; the pain in the forehead becomes gradually worse and extends, to the left side with nausea.

10:30, p.m. Heaviness in the whole forehead, pain in the sacral region. The second day, the stool which usually passed only by considerable straining, because of its solidity, was next morning soft and easily discharged. A customary burning of the urethra was diminished. This morning he took the other half of the solution. In the evening very offensive flatus; at night, very offensive diarrhea.

10. The same. Took in the evening Lithium carb.³ The whole next day, heaviness in the sinciput, especially in the frontal eminences. Lax feeling of the whole body, especially in the knee-joints and in the sacral region. Sometimes a sudden jerk or shock in the heart. General feeling of heat in the body. The first day the urine was redder, the next day more scanty.

11. Dr. Ch. Geist took, May 21st, 1846, at 7:30, a.m., fasting, one drop of the fifth. Immediately, pressure from without inwards, in both temples. The next day after breakfast, eight, a.m., one drop. Soon after a moderate pain in the left abdominal ring, like a pressing from within outward with confusion of the head in both temples, a dull pressure from without inwards. In the afternoon, pain and weakness of the feet; weakness in the sacrum, when writing, standing at a high desk. Evening very sleepy. At night restless dreams. The third day, in the morning, very sleepy, can hardly open the eyes.

8, a.m. Another drop. Pain in the sacrum when standing, with confusion of the head.

12. The same. July 7th, five, a.m., two drops of the fifth potency. Immediately, pressure in both temples from without inwards, with a pressing pain in the middle of the chest outwards, towards both sides, in the region of the fourth rib.

13. Dr. Neidhard gave it to a patient who had decided induration of the aortic valves, with the following symptoms: a bruit de scie followed by a bellows sound within a small space in the region of the aortic valves. Sharp pains shot through the heart towards the back; through the shoulder into the arm; the arm as if paralyzed. After Lithium carb.³ trituration, given in the evening, a more violent paroxysm than usual; which was renewed on going to bed; he had to rise again and remain sitting up. His face became blue; pulse weak and slow, almost vanishing; the heart acted languidly. The attack differed from former ones, in that mucus and blood were expectorated. After this the condition of the patient improved wonderfully, astonishing his attendants, yet no diminution of his objective symptoms was perceptible. At the end of a week he grew worse and died. The autopsy showed ossification of the aorta and of its valves.

14. Dr. Felger tried Lithium, by my advice, on a woman who suffered from ulcers of the bladder and kidneys, that were probably incurable. A grain of Lithium carb. was dissolved in a glass of water, and a table-spoonful of the solution given three times daily, for five days. He reported as follows:

Mrs. H., aged 52 years, who, of her fifteen children, had lost thirteen before they reached their fourth year, has been constantly ill since her second marriage, eighteen years ago; for several years bedridden, and for the last year homoeopathically treated with low potencies, and ostensibly for hemorrhoids of the bladder; has taken Ars. citr., Sulph., Nux vom., Con., Caust, Kreasot, Graph, and preparations of Antimony without effect, until at last the reporter resorted to frequent catheterization for the relief of the vesical pains with violent tenesmus.

September 25th, eight, p.m., the first dose. Violent sticking pains in the bladder so that she must sit up; pains continued until a piece of the mucous membrane of the bladder and concretions came away from the bladder; increased heat and burning in the bladder until one o'clock at night, when it became a little better. The pains in the limbs were at the same time more tolerable than usual.

September 26th. In the morning, soft, abundant stool, which for months before had been scanty, hard and very difficult. After stool, increasing heat in the limbs as always during the whole illness. Also the pains in the head increased, became tearing and sticking upon the right side, more violent than ever towards morning; worse on assuming the upright position and on motion, better during repose; sticking pains in the left hypochondrium. Evening, heaviness in the legs, as if she had one hundred pounds in them, the feet swell. The urine was diminished by one-half, but the deposit increased and the odor was ammoniacal. From the silver catheter, without which she could not pass water, the discharge was at first black. In the evening again, tenesmus until the discharge of a membranous fragment.

September 27th. After headache, all night, till four, a.m., pressure to stool, which occurred at six, a.m., twice and was soft. At stool the headache goes to the nape of the neck and down the back into the thighs. The pains above become less severe, but below more so. During the day, in spite of a bitter taste and excessive thirst, a better appetite, slept very much, and was free from pains in the limbs. Sticking in the right hypochondrium.

September 28th. The burning pains in the bladder more violent and discharge of urine increased; with less pain in the limbs, increased disposition to sleep. Tearing and pressure in the left abdomen and less appetite. Coldness of the feet, especially of the soles; then sudden heat, which begins in the soles and extends thence into the legs; more thirst.

September 29th. Pains in the limbs and head increased, especially on the right side, so that she cannot lie upon it.

7, a.m. Soft stool, violent sticking pains in the bladder, and burning on urinating; urine increased, blood red, with a reddish sandy deposit; general heat, constant thirst, entire loss of appetite. Last night, sour eructations, which taste, as soon as they come into the throat, like the last food.

September 30th. Vomiting of mucus attended by violent pain with a sharp, bitter taste in the mouth. Pains in head and limbs much increased, with violent, burning pains in the abdomen, constant thirst with aversion to drinking. The whole night, anxiety and restlessness.

October 1st. Pains continue; stool hard and difficult; sticking in the abdomen; no appetite; thirst for water, will not drink because it makes her vomit. The teeth feel dull, numb and loose, so that she cannot bite. Urine bloody, with a sandy deposit. The patient had taken about sixteen tablespoonfuls of the solution, but from the beginning with great aversion, because “the water has a very offensive taste like pitch or horn” and now she positively refused. The only alleviation, up to the time of her death, was the frequent discharge of water through the catheter. The autopsy showed an almost complete destruction of kidneys and bladder; the bottoms of the ulcers were full of concretions of Uric acid, of mucous deposits and pas. The very decided and enduring increase of the pains resulted from the gradual increase of the doses. Whether smaller doses would have done more is very doubtful (why so? — C. HERING).

The action of the remedy may be recognized in a few symptoms. If the urine were analyzed daily, a daily increasing dose of the Lithium would afford very interesting results. — Dr. FELGER.

15. Mrs. P. took, August, 1853, the sixth dilution, about six, a.m., eight globules, on two successive days. Observed that it had an effect, but was compelled to visit a sick friend and then to take upon herself the cares of the household. An unpleasant feeling in the head and stomach, might be due to these disturbing causes. She watched one night by the corpse, was exposed to the night air in cold weather, but the next night slept very well at home, but was wakened early by a pain in the abdomen, followed by diarrhea which was repeated now and then the next day, had five or six more stools without much pain. Gentle pains on the two ensuing days. She took therefore nothing more until fully restored to her usual state of health. She then began to take, evening and morning, twelve globules of the fifth. The first forenoon the same pain returned, the same gnawing sensation in the stomach which increased almost to vomiturition. It increased about dinner time, yet she ate without repugnance. Afternoon, pain in the right side of the face from the root of a tooth (which had been sawn off) up towards the temple; not severe, but continuing a long time. Evening, between nine and ten o'clock, she took the same dose. The night was undisturbed. In the morning the same dose. After breakfast, she felt the same pain in the left side of the face. It went from the throat into the left ear and caused earache. At the same time very gentle and brief pain in the left temple. The pains on the left side were more violent and lasted longer than the pains of the day before, on the right side. Before meal-times, especially before dinner, the same gnawing sensation in the stomach. The third morning, all these symptoms were still more severe. The gnawing began about an hour before dinner, accompanied by pain in the left temple, which extended into the orbit. The appetite was good and the gnawing sensation passed away “while she was eating and so at last also did the pain in the orbit, which however came back about fifteen minutes after the meal and at the same time was felt in the right temple. The whole afternoon a fullness remained in the temples. Soon after supper, a sensation as if a heavy, hard body were in the stomach, only for a short time. She therefore ceased, this evening, to take the medicine. Next morning, on rising, a pain or rather a feeling of soreness on the right side, near the spine, below the loins in a spot not larger than the end of the finger, sensitive to the touch; continued the whole day until bed time. Next morning (the fifth day), after rising she bent forwards over the bed and felt instantly a very violent pain in the region of the heart Before meals, when driving, easily nauseated; fullness in the temples; the latter lasting the whole afternoon and evening, with some pain in the right ear. During the night, but little sleep, without further cause, also without restlessness, not disturbed by any symptom, except the above pain near the spine, and which seemed to change to a dull pain in the sacrum, which did not pass away until she got up. The menses occurred three or four days later and were diminished. On the second day of their flowing, while she was reading, she was obliged to get up and go out of doors for a short time. When she came back and took up her book again, she noticed an uncertainty of vision and an entire vanishing of the right half of whatever she looked at; or if two short words occurred in succession, that on the right hand was invisible. She tried each eye, alone; it was the same with both. At the same time, pain over the eyes and tension, as if bound, in the temples. This ceased while she was eating, but soon after eating it came again as an unpleasant sensation in the temples and remained, as a pressure, until in the night and seemed to go away during sleep. Later, nothing else was remarked except now and then rheumatic sensations in the legs.

16. The same person took (one week later) the same preparation again, morning, evening and morning. After ten or twelve hours, pain at the outer end of the right brow, gradually extending to the temples and about the ear. On awaking in the night, rheumatic pain in the right foot, passing away on rising. The next day, towards evening, pain and heaviness over the brow and restlessness in the stomach, unaltered by the evening meal and by walking out, lasting until she fell asleep.

The following day, pain in the right thigh in front and toward the outside, in a small spot, as it were the seat of insertion of a muscle. Once, a transient pain in the left temple. More than twenty-four hours after the last dose, when walking, pain through the hollow of the left foot, extending horizontally to the outside of the foot and thence along the leg to a little below the knee. This pain was the most violent and most persistent.

Three days after ceasing to take the medicine, the same returned in the right thigh, also now and then again in the right brow, where the action of the medicine had first of all begun to show itself. After a long walk, on a very warm day, she had great soreness of the corns, which had not troubled her so for a long time before.

17. The same took the same dose, but after breakfast, and very soon afterwards took a walk. During slow driving, a transient pain in the left temple, then in the right brow. When walking, pain in the left foot, similar to that in the foregoing proving, but not so extended. Heat in the eyes. Towards evening, tension in the temples and heaviness in the forehead. Pain in the left hip as before, in the night. Pain in the heart. The menses a few days later and also less in quantity. It seems to her as if the symptoms occurred earlier when the remedy is taken after breakfast. Before the menses, the symptoms were most violent on the left side, after the menses on the right. The eyes pained during and after reading as if dry and the lids especially were sore.

18. As the eighteenth proving, I take the liberty of presenting a proving, if I may venture to call it such, of the foregoing seventeen. For I would rather, myself, here, once for all, attach all the notes of interrogation and exclamation which might, by many persons, be subjoined with “little wit and great delight” to this word proving!

Not one of these seventeen correctly detailed reports is, strictly speaking, a proving, if we apply to it the standard which might certainly, with more or less propriety, be applied, and should be applied before we give to such experiments a name, which those manifold models that have been given us, deserve. The foregoing seventeen are all, taken one with another, only skirmishings, preliminary reconnoisances, scoutings into an unknown region — and they should be nothing more than this. That they extend over a period of ten years, alters nothing in the plan. But to what end? and why? And then, to print such a precious medley!

To the first interrogative, thus much of an answer may be given. A prover's society which was proposed to be widely extended, was to have been established, was actually founded, but soon fell in pieces, because it received no “encouragement.” Let nobody reproach us in America for this. The very same thing occurred, yonder in Germany, at the very same time, and singularly enough without any concert of action.

Only remedies which were already known, at least provisionally, to be great remedies were to be selected for proving; every year one remedy was to be chosen, and one remedy to be proved by all, in one and the same year, and by many provers. The copy of the reports would have made an annual of the greatest value. But they would not carry out the plan. Now not only would such preliminary experiments, as these cause many remedies to be regarded as worthy of selection for proving, but by making the results known, votes would be gained, This is the reply to the exclamation. Notwithstanding that the foregoing reports if taken singly can with little trouble be “snapped like pipe stems,” yet very much that is important has already resulted from them. An eye-symptom was the first symptom, and an eye-symptom the last symptom. And, already, a large number of eye-diseases, both those of daily occurrence and those of rarer chronic character have been cured by this remedy. When time shall be found, to seek out these cases from the books of clinical record, the peculiarities shall be communicated.* [In June, 1862, L. K., reports, a tobacconist and his daughter took cold in the rain, especially in the feet: they got ophthalmis, the sclerot. c was red, the lids agglutinated by muco-pus. The father had sticking pains in the eyes, very frequent congestion of the head and cool copious sweat of the head. After Lith. 12, he was able to work the next day. The daughter had a jerking together and around in the reddened eyes and a veil before them; could not see, and had such photophobia that she applied a bandage over the eyes. The right eye was worse; the left affected later and less severely. This grew better the first day after Lith. 12, and the right eye on the third day: the fourth day she is well.]

The heart-symptoms have already proved themselves to be a second angle of the triangle. Let the comparison which was made in the preceding pages on scientific grounds, between the salifiable substances and the alkalies, be recalled to mind and then the remark under Bromine, Archiv. 22, 3, 113, that the eyes and lungs, especially, are affected. When we shall have made more experiments upon these two remedies, a very important place may be attained by Bromide of Lithium by means of a very few provings.

The very distinct action of Lithium upon the kidneys and bladder, may even now be regarded as the third angle of the triangle which we are thus already able to draw in the sphere of action of Lithium. This is sufficient and it fully justifies us in making a comparative collection of the symptoms. W e have now a key in reading them, when we find everything brought together in each place. That which is more certain and that which is less so brought together in such a way that we can sift and separate as it were “in the mind.” That, by this process, a large number of symptoms fall into the shade, is a matter of course; but, on the other hand, others, by the same intellectual process are brought so much the more into the light, as we read. Erasure is easy, and so is a critical crumbling of a subject to pieces, but to keep hovering with steady wing-strokes, over the details as they are arranged side by side, to maintain a sharp look-out and to choose with artistic accuracy — this will lead us to cures far sooner than all the erasures and the crumbling. It requires, assuredly, more intellectual muscular-force and greater sharpness of the intellectual senses; but by frequent practice it is not so excessively difficult to attain.

Young people can always learn it. Imagine a person, sufficiently versed in our Physiology and Pathology, so that when reading the symptoms, he can do a little thinking between the lines, or strictly speaking, upon the lines. We must assume that when one is tolerably familiar with our Materia Medica, every somewhat striking or prominent symptom he meets with, calls to his mind at once other remedies which have the same symptoms but either under opposite conditions or in different connections. For such a person it cannot be regarded as useless to give here a completely elaborated resume of symptoms, even though this should be merely preliminary and an invitation to more provings, to provings more properly so styled.

SUMMARY OF SYMPTOMS.

ABBREVIATIONS.

1. Observed by the operator while triturating.

2. C. Hering, a., from a half grain of the third trituration.

3. ” b., from five drops of a solution (1-100) of what had been caustic Lithium.

4. S. ” c., from the thirtieth repeated.

5. R.a., the thirtieth dilution.

6. R.b. “ ”

7. G. a. “ ”

8. G. b., from the third trituration.

9. Neidhard, a., from the first centesimal.

10. “b., from the third centesimal.

11. Geist, a., from the fifth dilution.

12. “b.,.

13. S. Neidhard, from the third dilution.

14. S. Felger, solution of the crude substance.

15. P. a., from the sixth.

16. P.b., ”

17. P. c. ”

S. Designates symptoms on the sick

* Cures.

1. Disposition to weep about his lonesome condition so that he weeps even to sobbing, the nose becoming full of water. Second day. R. a.

S. The whole night anxiety and feeling of helplessness. Felger.

Palpitation after mental emotions. *181.

(Power to recollect names is still weaker than common.) Second day. — C. HERING. b.

5. Painful confusion on both sides, R., after ten minutes. C. Hering.

(C. HERING. The same with headache, 108, with pain in the sacrum, 187.)

Heaviness in the whole forehead. Neidhard, a. Compare 21.

Heaviness in the sinciput, especially in the frontal eminences, the entire next day. Neidhard, b.

Pressive pain in the forehead on the right over the eyes, then on the left with nausea. 101.

The pain over the eyes and tension, as if bound in the temples, diminished while eating, but came again soon after eating and remained as a pressure in the temples until in the night, and seemed to go away only after falling asleep. P. a;

10. Towards evening, pain and heaviness over the brows, with restlessness in the stomach, unchanged by eating supper and by walking out, continuing until he goes to sleep. Second day, P. b.

Pains in a small spot in the right temple. 265.

Pain in the left temple (67) extending to the orbit. 98.

Fullness in the right temple, the whole afternoon. 40.

Pressure in both temples from without inwards; immediately. Likewise, dull pressure with confusion; the second day. Geist, a.

15. Pressure in both temples from without inwards, with a pressing pain in the middle of the chest, extending outwards and towards both sides, in the region of the fourth rib; immediately. Geist. b.

When driving, before dinner, easily nauseated and fullness in the temples. The latter continues the whole afternoon and evening with some pain in the right ear. Fifth day, P. a.

Tension as if bound in the temples, with half-vision. 33.

Pain in the temples, originating in the brows. 51.

Transient pain in the left temple. Third day, P. b.

20. Pain in the left temple, when driving in a wagon, then, in the right brow. P. c.

Towards evening tension in the temples and heaviness in the forehead. P. c.

S. Tearing, sticking headache on the right side, worse on assuming the erect posture and on motion, better during repose. Felger.

Pain in the left parietal bone, after belching. 80.

A sticking burning sensation passing from below upwards, first in the left side of the head, then in the right malar bone; after a few minutes in the epigastrium. C. Hering.

25. Headache on the vertex, right side, superiorly, like a stitch, externally sensitive to pressure; after two hours, a. The same; evening of the first day, a. The same; b. after two hours, and later on the left side. C. Hering.

Headache in the left vertex, a kind of stitch, morning of the second day. G. a.

S. Early on awaking, violent headache in vertex and temples (after sudden cessation of the menses), second and third day; less on the fourth and fifth days; but on the sixth day, in the afternoon, again very severe in the left eye, the temple and a small spot in the occiput; in the temple and vertex very severe with nausea; endeavored to induce vomiting with warm water in the hope of getting relief, but in vain. Heavy weight upon the vertex with pressure upon the left temple, the whole head is as if too large; at the at the same time it feels as if it were violently squeezed (angepackt) in a small spot which greatly increases the nausea. Could hardly keep the eyes open; they pained as if sore from morning till noon; when looking at anything, the headache grows worse. She can't continue lying down; it pains everywhere; somewhat better when sitting; relieved by going out. C. Hering, c.

The pain in the heart extends into the head; it is a trembling and throbbing. *181.

Unpleasant feeling in head and stomach. P. a.

30. Toothache, going up into the temple. 67.

Head seems too large. 27.

Head externally sensitive. 25.

On the second day of the menses, after being obliged to get up from reading and go into the open air, she noticed, on taking up the book again, an uncertainty of vision and an entire invisibility of the right half of whatever she looked

upon; if two short words occurred in succession, the one towards the right hand was invisible. She tried each eye singly; it was the same with both eyes; at the same time a pain over the eyes and a tension, as if bound in the temples. P. a.

Although the day is obscured, the sun-light blinds him upon the streets, after thirty minutes. C. Hering.

35. When looking at anything, the headache gets worse. 27.

When reading the eyes are affected. 44.

Stitches in the right eye, after triturating.

Eyes pain as if sore, forenoon. 27.

Pain in the orbits proceeding from the temples, better after eating. 98.

40. The pain in the orbits, when driving in a wagon, before dinner, and which went away when eating, came again, fifteen minutes after eating, and at the same time in the right temple; and there remained, the whole afternoon, a fullness in the temples. Third day. P. a.

Pains internally in the globe of the right eye, above the external canthus, after six minutes. C. Hering.

In the right inner canthus a cooling sensation as if from salt, after five minutes. C. Hering.

Pains in the eyes as if little grains of sand were in them; the left pained much more than the right; when triturating.

The eyes pained during and after reading as if they were dry and ailing; especially the tarsal margins were sore. P. a. b. c.

45. Feeling of dryness in the eyes although they were moist, worse in the left; also feeling as if sand were in them. 27.

Sore pain and feeling of dryness in the margin of the right upper lid; forenoon of the second day. C. Hering, a.

Cannot easily open the lids; with sleepiness in the morning. 235.

Could hardly hold the eyes open during the headache. 27.

Fain over the right eye towards the outside, then above and in the right knee, as if toward the patella, after twenty minutes. C. Hering.

50. Throbbing, drawing pain about the right eye, around, outside, above and deep in the orbit, after thirty minutes. C. Hering.

Pain at the outer end of the right brow, gradually extending to the temple and ear, after one day. P. b.

Pain in the region of the right eye-brow. 20, 219.

Pain over the eyes, with half vision. 33.

Heat in the eyes. P. c.

55. Pain in the right ear. 16.

Pain behind the left ear, in the bone, extending towards the neck, after three hours. C. Hering.

Ear ache, left side, from the throat, with prosopalgia. 67.

Pain about the ear. 51.

Nose obstructed, above and in the forehead, morning and whole forenoon. R. a.

60. Must, in the evening, use the handkerchief very much; much mucus remains behind in the choanae. First day. C. Hering, b.

Dropping from the nose, in the open air; also later in the room; repeated. C. Hering.

Nose full of water when weeping!

Nose, especially on the right side, somewhat swollen, red, sore internally — shining crusts form in it; it is dry and as if inflamed (at the same time frequent urinating at night, disturbing the sleep). R. b.

Pain in a right lower back tooth, after twenty minutes. C. Hering.

Toothache in a left lower back tooth, late in the evening. First day. C. Hering.

65. Now and then, toothache, on right, the side, behind, after four hours. C. Hering, b.

S. The teeth seem dull, numb and loose, so that she can not bite. Felger.

Pain in the right side of the face, afternoon, from the root of a tooth that has been sawn off, extending to the temple. The next morning, the same pain, left, in the face, passing from the throat to the left ear, causing ear ache and a moderate brief pain in the left temple. The pains on the left side were more violent and more enduring than the pains on the right side the day before, The first and second days, P. a.

Feeling in the throat as if it were sore, after two hours. C. Hering.

Evening, eight to nine o'clock, sore throat, behind, right side, in a corner; when swallowing as if sore. The first day. C. Hering.

70. Sore throat extending into the ear (67) and from ear to throat. 56.

Expectoration of mucus from the choanae (compare 60) and out of the fauces in solid lumps, especially morning and forenoon, the first three days. R. a.

Hawking up mucus in large quantities. 169.

Irritation, provoking cough, in the throat. 170.

Good appetite, with gnawing in the stomach. 97, 98.

75. Decreasing hunger from the first day onward; the fourth day neither, in the morning desire for breakfast nor appetite during the day; as soon as he begins to eat, the appetite is at once satisfied. C. Hering, b.

No desire for wine, beer, coffee,. sugar, etc.; the fourth day. C. Hering, b,

Before dinner, fullness in the temples. 16.

Before dinner, the gnawing in stomach is worse (97); before every meal. 98.

When eating and drinking, immediately all further desire ceases, yet without aversion; for several days. C. Hering, b.

80. Sluggish, belching eructations, before dinner, then, pain in the left parietal bone; after three or four hours. C. Hering, b.

While he eats, the gnawing in the stomach goes away (98), and so do, also, finally, the pains in the left temple and orbit (98), and the headache gets better. 9.

The headache returns again after eating (9), and so do the pains in the orbits. 40.

After the evening meal, heaviness in the stomach. 96.

Nausea, with fullness in the temples (16) with headache. 37,101.

Note. — (Symptoms 85-90 of the manuscript have been blended with the above.)

90. Nausea and gnawing in the stomach. 97.

Gulping up (contents of the stomach) after watermelon; the fifth day. R. a.

After breakfast, when walking, constriction of the chest. 169.

*Acidity in the stomach was relieved by nothing so quickly as by Lithium¹². Very often. R.

Painless, but unpleasant, tensive pressure upon a small spot in the neighborhood of the stomach, to the right of, below and behind the pit of the stomach; after three or four hours. C. Hering, b.

95. Fullness in the pit of the stomach; could not endure any pressure of the clothes; pressure with the hand, she thought, would have caused vomiting. Morning before breakfast; second day. G. a.

Soon after supper, sensation as of a heavy, hard body in the stomach a short time; third day, P. a.

Gnawing sensation in the stomach, which increased almost to nausea, the whole forenoon, increasing towards dinner time; yet she ate without aversion; first day. P. a.

Before meal time, especially before dinner, the same gnawing sensation in the stomach, the second day; the third day, it began one hour before dinner, accompanied by the pain in the left temple which extended into the orbit. Appetite good. The gnawing sensation ceased during the meal, and so did finally the pain in the orbit; third day. P. a.

Restlessness in the stomach with pain over the brows. 10.

100. Unpleasant sensation in the stomach and head. 29.

Pressure in the hepatic region and gentle pressing pain in the right side of the forehead; later over the eyes. The forehead-pain extends to the left side, with nausea, after one hour. Neidhard, a.

Violent pain in the hepatic region, between the ilium and the ribs. S. a.

S. Sticking pain in the left hypochondrium, later in the right. Felger.

Pain in the epigastrium. 24.

105. At noon the whole abdomen feels swollen and as if distended with wind, the third day. R. a.

Violent pain transversely in the abdomen in the upper part of the vesical region; after two hours. C. Hering.

Pain in abdomen, waking. Gentle pains in the abdomen, several days. P. a.

Pain in the left abdominal ring, like a pressing from within outwards, with confusion of the head and dull pressure from without inwards in Loth temples; the second day. Geist, a.

Violent painful dull stitch in the perineum near the anus from above downwards, from within outwards; when walking, eight o'clock, p.m.; the first day. C. Hering.

110. Very sharp quick short itching in the anus, evening after nine o'clock; first day. C. Hering.

After dinner, two, p.m., a hard stool, the first since the day before taking the remedy; second day. C. Hering, a.

The stool omits, the first day; the next day it is, first, hard, then soft and light yellow. C. Hering, b.

A second stool in the morning. R. a.

Nine, a.m., a stool, and one again at one o'clock, p.m., with micturition; second day. R. a.

115. The stool, which was usually passed only by great effort on account of its solidity, is soft the next morning and passes easily; the second day. Neidhard, a.

S. Soft, abundant stool in the morning; it had for a long time been hard and difficult. Felger.

S. Early, soft stools. Felger.

At night, very stinking diarrhea. Neidhard, a.

Diarrhea immediately after drinking chocolate; the fourth day. C. Hering.

120. Diarrhea after fruit, for a week. R. a.

Diarrhea and stomach ache wakens him early, it is repeated five or six times during the day, without pain. P. a.

Numerous small emissions of rotten-stinking flatus; first to third day. C. Hering, b.

Frequent very stinking flatus from three to ten, p.m.; third and fourth days. R. a.

Very stinking discharge of flatus; evening. Neidhard, a.

125. Restlessness in the region of the kidneys; fifth day.

R . a.

Feeling as if the bladder were affected after twenty minutes. C. Hering.

Sensitive pain, sharp pressure, in the vesical region, more on the right side; after two-and-a-half hours, about ten minutes after passing water. C. Hering.

Tenesmus vesicae and micturition, evening, eight to nine o'clock, when walking in the street; always before and for some time afterwards the Lithium pains in the region of the neck of the bladder or other neighboring parts; first day. C. Hering.

Pain in the region of the neck of the bladder on the right; evening of the first day. C. Hering.

130. Before passing water, flashes of pain in the region of the bladder, inferiorly, more towards the right; after urinating, pains extending into the spermatic cord, more on the left; second day. C. Hering.

Pain in the bladder (239), in the upper part. 106.

Pain in the bladder, the whole fourth day; in the afternoon of the fifth day. R. a.

8. Increase of the pains and symptoms of the ulceration of the bladder. Felger.

Very fine itching stitches through the pubis, passing from behind forwards transversely, suddenly and in a curve, like lightning; afterwards a continuous pain. R. b.

S. Tenesmus vesicae and micturition.

135. Quick, strong tenesmus; the dark, yellowish urine in much smaller quantity (only seven ounces instead of nine to eleven ounces) formerly produced no such tenesmus; five minutes later, sensitive pain in the middle of the urethra, a pressure without tenesmus; the second day. C. Hering.

Subsequently when a desire to urinate is felt, it is possible to retain the urine for a longer time; the urine is clear, frothy and measures thirteen ounces — more than he had otherwise been able to retain for so long a time; morning of the second day. C. Hering.

Very frequent micturition the whole afternoon; second day. R. a.

Frequent urination; fifth day. R. a.

Tenesmus vesicae when waking at night. 240.

140. Urination, when waking; then erection. 239.

Urination painful. 150.

On rising to urinate, a pressing in the region of the heart, which did not cease until after urination; morning, the second day. C. Hering, a.

Passes less urine although he drinks as much as usual; the first day. C. Hering, b.

Frequent and copious urination; the second day. R. a.

145. Less urine, at night. 239.

After urinating, a voluptuous titillation in the urethra; morning, the second day. R. a.

The urine is turbid, but does not, as formerly, form a cloud or deposit a sediment; morning. The urine passed in the forenoon becomes again quite turbid and forms only a scanty flocculent deposit; second day. C. Hering.

Turbid urine with much mucous deposit; subsequently the urine remained clearer than it had been for a long time. G.a.

Urine red, the first day; the next day less so. Neidhard, b.

150. Urine more scanty and dark, very acrid; it pains when being passed, like lye upon an irritable surface, and the evacuation is at the same time more difficult; morning, third day. R. a.

Dark reddish brown deposit, for more than a week. G.

S. The urine is diminished one-half, the sediment increased, the odor ammoniacal. Felger.

*Very frequent urination, disturbing in sleep. 62.

Pains on the right aide in the ureter and through the spermatic cord into the testicle. G. b.

Fain in the urethra. 135.

155. *Barning in the urethra. Neidhard, a.

Voluptuous titillation in the urethra, at night on awaking. 239.

Titillation in the urethra, on urinating. 146.

Erection after urinating, at night. 289.

Erection, passing away after urinating. 240.

160. Pain extending into the spermatic cord, worse on the left. 130.

Pains in the testes. 153.

In the evening, eight o'clock, when sitting, in the penis on the right side and at the root of the penis, the peculiar throbbing stitch of Lithium; second day. C. Hering.

The menses suddenly cease and headache comes on. 27.

The menses are three or four days later and diminished. P. a. c.

165. When taken before the menses, the symptoms were most violent on the left side; when taken after the menses, on the right side P. a. b. c.

On inspiration, the air feels bo cold that it seems to be felt unpleasantly even in the lungs. *181.

Pressive pain in the middle of the chest, from within outwards, towards both sides, in the region of the fourth rib. 15.

Again in the afternoon, pressure in the middle of the chest; fifth day. R. a.

Constriction of the chest when walking out, after breakfast, then expectoration of mucus in great quantity brought up by hawking; the mucus seems to come from the middle of the sternum; fifth day. R. a.

170. Violent cough, late in the evening, while lying down, compelling to rise, without expectoration; the irritation, which provokes the cough, is in a little spot, posteriorly and interiorly in the throat. Cough consists of very quick shocks which do not seem to come out of the chest but out of the throat and to be very violent and prostrating in short paroxysms; fourth day. C. Hering, b.

Shudder, which starts from the chest, and extends over the anterior superior surface of the, body, with a contracting sensation; after half an hour. C. Hering.

Pains in the region of the heart, throbbing, like a dull stitch, lasting five to ten minutes; after two hours. C. Hering.

Sometimes a sudden shock in the heart; second day. Neidhard, b.

As she bent forwards over the bed, in the morning after rising, a very violent pain in the region of the heart; fifth day. P. a.

175. Pain in the heart. P. c.

Pains in the heart, after pains in the bladder. 127.

Pressure in the region of the heart on rising to urinate; passing away after urination. 142.

*Rheumatic soreness in the region of the heart. Neidhard.

* Pains in the heart, before and at the time of the commencement of the menses. C. Hering, c.

180. S. Aggravates the pain of the paroxysms in a case of ossification of the aortic valves. Neidhard.

* Often, in deficiencies of the valves especially after mental agitation of a vexatious character, to which she is very subject, a trembling and fluttering of the heart, distressingly painful in the heart and as far as between the shoulders. It extends upwards also into the head where it is felt as an equally painful throbbing. At the same time the air, on inspiration, seems so cold, that it is felt unpleasantly cold even in the lungs. Lithium“ in water gave relief. C. Hering.

In the morning, on rising, a feeling of soreness on the right side near the spine, below the loins, upon a spot not larger than the point of the linger, sensitive to pressure. It continued the whole day until he lay down at night; fourth day. P. a.

Near the spine, pain in a small spot, the whole night. 236.

Stitch in the sacrum, ten, p.m.; first day. C. Hering.

185. Pain in the sacral region, after one hour and a half. Neidhard, a.

Weakness in the sacrum when writing at a standing desk; second day. Geist, a.

Pain in the sacrum, when standing, with confusion of the head; third day. Geist, a.

Dull pain in the sacrum, at night (236); feeling of prostration (abgeschlagen) in the sacrum. 231.

Pain on the anterior side of the right shoulder-joint near the point of insertion of the pectoralis major muscle on the margin of the same; after half an hour. C. Hering.

190. The left hand is painful. 232

In the evening, sweat of the back of the hand, while the palms are dry; the fourth day. JR. a.

In the evening, pain in the metacarpal bone of the little finger of the left hand; first day. C. Hering.

Burning stitch in the ball of the hand, compelling to scratch. 197.

Burning stitch in the ball of the left thumb; after four hours. C. Hering.

195. Itching, throbbing, very sensitive pains in all the fingers, especially in the second and third fingers of the left hand, as if it were in and upon the bones, extending from the hand to the ends of the fingers, only during repose; it ceases upon pressure, when grasping, and during motion; after five hours. C. Hering.

Had rubbed a spot sore on the left middle finger two hours before taking Lithium; after two hours, the finger pained, the pain drawing towards the sore spot. C. Hering.

Pain along the right middle finger extending towards the extremity; later in the left middle finger; at the same time, in the ball of the hand, a burning stitch, compelling to scratch; after four hours. C. Hering.

The left middle finger very painful, through and through, after four hours. C. Hering.

In the evening, internal itching of the left middle finger near the nail, and around on the left side of the finger; first day. C. Hering, b.

200. Soreness at the margin of the nail, redness and pain, more at the external angle, first of the left thumb, then of the right fourth finger, then of several fingers of the left hand, then of the right middle finger; lasting several weeks. C. Hering, b.

Pain in the right hip; subsequently in the left. P. a.

Pain in the left iliac bone. G. a.

Itching, burning pain in a small spot on the right hip, then on the thigh, then on the little toe; all on the external aspect of the limb; after half an hour. C. Hering.

Occasional rheumatic pains in the lower extremities. P. a.

205. Pain in the right thigh anteriorly and externally, in a small spot, as it might be the point of insertion of a muscle; third day. P. b.

Considerable itching on the whole inner side of the right thigh, also upon a small spot of the adjacent parts, compelling to scratch till it becomes raw, late in the evening; first day. C. Hering, o.

Pain internally on the left thigh; after two hours. C. Hering

Itching sticking pain internally on the left thigh; after two hours. C. Hering.

8. Heaviness in the legs, evening. Felger.

210. Pains over the right knee, towards the patella. 49.

Sticking burning pain internally at the left knee, after a quarter of an hour. C. Hering.

Pain of the knees, or rather above them, especially when going up-stairs; after the first day. C. Hering.

Great weakness of the knees, on going up-stairs, after one or two hours, which entirely disappeared in the evening; first day. C. Hering.

Prostrated feeling in the knee -joints, 231.

215. Fain along the legs as far as the knee. 219.

Shin is painful. 232.

Fain from above downwards in the right calf; after two hours. C. Hering.

On awaking at night, rheumatic pains in the right foot; they pass away on rising; second day. P. b.

When walking, pains through the dorsum of the left foot, near the ankle-joint, extending horizontally to the external side of the foot and anteriorly up the leg to below the knee; third day.

Twenty-four hours after taking the last dose of Lithium the pain was the most severe and continuous. Three days after ceasing to take the medicine, the same pain came in the right thigh and occasionally in the right brow. P. b.

220. *Painfulness of the feet, ankles, metatarsus, all the toes, especially at the border of the foot and the sole, as it were, gouty. Dr. Whitey.

When walking, pain in the left foot. P. b. c.

Fain and weakness of the feet, afternoon; second and third day. Geist, a.

The ankle-joints pain when walking; first the right is the more painful, then the left, evening; first day. C. Hering.

Twitching pain from the Os Calcis into the middle of the right foot and through the foot; two hours. C. Hering.

225. Itching upon the sole of the left foot on the inner margin, compelling to a vigorous scratching; fourth day. R. a.

(The feet, especially the soles, are first cold, then hot.) 249.

Fain in the little toes. 203.

Burning in the great toe, especially around the corns, occasionally in different parts of the toe. Dr. Whitey.

Great soreness of the corns, after a long walk on a hot day. P.b.

230. A paralytic stiffness in all the limbs and in the whole body; after two or three hours, C. Hering, b.

Prostration of the whole body, especially in the knee-joints and in the sacrum. Neidhard, b.

Pain in the left shin externally, then in the left hand; two hours. C. Hering, b.

Over the whole body, as if beaten, stiff and sore in all the bones, joints and muscles. Bryonia gave relief. R. b.

Very sleepy in the evening; second day. Geist, a.

235. Very sleepy in the morning; cannot well open the lids; third day. Geist, a,

But little sleep at night, without any special cause, without restlessness, or pain, further than a pain in a small spot near the spine, which seemed to become a dull pain in the sacrum, and disappeared in the morning on rising; fifth and sixth day. P. a.

S. (Anxious and restless at night.) 2.

Sleep at night disturbed by urination. 62.

Voluptuous dreams; on awaking, urination and then violent erection and sexual excitement for one hour; after which he fell asleep and awakened two or three times again, with erection and tenesmus vesicae and a voluptuous titillation in the urethra; could not urinate, because of the erection; when he succeeded in doing so, the erection subsided completely; the quantity of urine less by two or three wine-glassfuls; at the same time pain in the bladder; first day. R.a.

240. Voluptuous dreams, tenesmus vesica, and erection which subsides after urination, on awaking; the second night. R.a.

At night, restless dreams; second and third day. Geist, a,

Stinking diarrhea, at night. 118.

Headache on awaking. 27.

(Stomach ache, waking one early in the morning.) 107.

245. Pains in the feet on awaking in the night 218.

On rising in the morning, the pain in the sacrum is relieved. 236.

On rising in the morning, the pain in the feet passes away. 218.

Shudder, starting from the thorax. 171.

S. Coldness of the feet, especially of the soles, then sudden heat beginning in the soles of the feet and extending over the whole body. Felger.

250. General feeling of heat in the body; second day. Neidhard, b.

Very copious sweat. R. a.

Sweat on the back of the hands. 191.

Itching at the anus. 110.

Itching in the middle finger around margin of the nail. 199.

255. Itching on the side of the thigh, compelling to scratch until that part is raw. 206.

Itching in the sole of the foot, compelling to scratch. 225.

Burning-stitch in the ball of the hand, compelling to scratch. 194. Ditto, in the palm of the hand. 197.

Itching burning in the hip. 203.

Itching sticking in the thigh. 208.

260. The pains draw towards an abraded spot on the finger. 196.

Redness and soreness of the nose. *62.

Redness and soreness of the margin of the nail of several fingers. 200.

Pressing, as if with a dull point, here and there, internally, as it were near the bone, most on the left side, evening; first day. C. Hering.

Burning stitch which goes from within outwards, and ends in an itching (felt decidedly within four hours). C. Hering.

The whole evening, frequent stitch-like pains, which press from within outwards, and end in a burning sticking in a small spot, most on the left side; evening, first day. C. Hering. Compare 194.

265,. Moderate pains, here and there, sometimes, becoming violent; most distinctly felt in a small spot on the right temple, for several days together. C. Hering, b.

Contracting sensation, with shudder. 171.

Pains in the bones. 195, 56,

Conditions.

Pressure with the hand is intolerable. 95.

The pains in the fingers are better from pressure, and on being grasped. 195.

On lying over forwards on the bed, pain in the heart. 174.

Cannot remain in a recumbent position; severe headache, relieved by sitting, diminished by going out. 27.

Only during repose, pains in the fingers. 195.

In repose, headache is better. 22.

270. When sitting, stitches in the penis. 162.

When sitting, the headache is better. 27.

When standing, pain in the sacrum. 187.

On assuming the erect position, headache is worse. 22.

When driving in a wagon, pain in the temples (20); fullness in the temples, and nausea. 16,

(During motion, the headache is worse.) 22.

During motion, the finger pains are better. 195.

275. Going out relieves the headache. 27.

On going out, constriction of the chest. 169.

When walking, stitches in the perineum (109); tenesmus vesicae (128); pains in joints (273); in the foot. 219, 221,

On going up-stairs, pains in the knees. 212.

Weakness in the knees. 213.

Chocolate causes diarrhea (119); fruit also. 120.

Water-melon causes a gulping-up. 91.

Bryonia relieved the pain as if beaten. 233.

Morning, pain in vertex (26); nose obstructed (59); pain in face, left side (67); fullness in the epigastrium (95); pain

in the heart (174); expectoration of mucus (71): stool (113, 114); soft stool (115, 116,117); titillation in the urethra (146); long retention of urine (136); turbid urine (147); pains in the heart (142); pains near the spine (182); sleepiness. 235.

280. The symptoms appear to set in sooner when the remedy is taken after breakfast. R. a, b. c.

Forenoon, pains in the eyes (27); nose obstructed (59); expectoration of mucus (71); gnawing in the stomach, increasing before dinner (97); turbid urine. 147.

Noon, abdomen distended (105); one, p.m., stool. 114.

Afternoon, headache worse (27); fullness in the temples (40,16); pressure in the temples (9); pain in the face, right side (67); two, p.m., stool (111); offensive flatus (123); pain in the bladder (132); frequent urination (137); pressure on the chest (168); pains in the feet (222); towards evening, tension in forehead (10); tension in temples. 21.

Evening, headache (25); fullness in the temples (16, 40); pressure (9); pain over the brow, on going asleep (10); toothache (64); sore throat (69); heaviness in the stomach (96); stitch in the perineum (109); itching of the anus (110); offensive flatus (124); tenesmus vesicae (128); stitches in the penis (162); cough (170); stitches in the sacrum (184); pains in the hand (193); itching of the fingers (199); sweat of the back of the hand (191); the legs are heavy (209); itching of the thigh (206); paint in the ankles (223); sleepiness (234); pains are worse. 262, 264.

285. From above downwards, pain through the thigh (203); pain in the calves from above downwards. 217.

Pains in the foot, going toward the toes. 224.

Pains in the fingers going towards the ends of them, 195,197

From below upwards, in the head. 24.

290. From behind forwards, stitches through the pubis. 134

First on the right side, then on the left; after five hours. C. Hering.

Headache (25); pain in the forehead (101); pain in the middle finger (197); pain in the ankle joint (223); pain in the face (67); pain in the hip. 201.

In the head and malar bone (24); pain in the left temple and then in the right brow (20); temples (40); in the left foot, then in the right thigh (219); on the left side, when taken before the menses, on the right when alter them, (165); on the left side, the pains are worse than on the right. 67.

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