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days, and the burning (nay, sometimes cutting) pain in the urethra was particularly marked. Now came Cantharides, Nux vomica, and Sulphur in succession, yet the pains remained constantly the same, till at last I lighted on Kali bichrom., after which, within two days, the pain was strikingly diminished, and had nearly disappeared in a week after; but the deposit of mucus all the time underwent no diminution, and now an accurate testing of the condition of the urine showed that it was when first passed turbid, as if intimately mixed with the mucus, and not until the second or third hour did the thick masses settle to the bottom. Red test-paper was coloured blue, and also the smell of the urine was sharply ammoniacal, a phenomenon to be explained by the fact that the copious mucus of the bladder was decomposing the elements of the urine. In succession now Dulcamara, Galcarea carbon., and Natrum carbon, were given, from the two last of which, and especially Calc. carb., a favourable effect, viz. manifest diminution of the mucous secretion, could be observed. The observation of this determined me to give the patient a wineglass of the Wildung Spa water, which is so extremely rich in Carbonate of Lime, every night and morning. The essential service rendered by this calcareous spa was soon manifested; and that not only in the visible diminution of mucus (and thus too in the abatement of ammoniacal odour), but also in the complete disappearance of the burning pain. After taking the Wildung water for barely four weeks, the patient was at last perfectly cured.
Thlaspi bursa pastoris in Metrorrhagia.
Last year I received a letter from England, sent by one of my patients, a young widow, whose state of health caused her great alarm. She informed me that three months previously she had had an attack of icterus of no great severity, and that for two months sbe had suffered from a continual discharge which came on after the menses.
* Bull, de la Soc. Med. Bom. de France.
She had been treated without success for this discharge by several medical men, who had given her among other remedies Cocculus, Sulphur, and Gonium, They had also strongly recommended the use of generous wines, but not being accustomed to them she felt all the worse for them. She suffered much from pain in the region of the right ovary extending to the knee; her stomach and bowels were frequently deranged, she lost her strength, and fell off visibly. She desired to return to France, but feared she might not be able to stand the journey but be laid up somewhere on the road.
Judging that the climate, the treatment, and the regimen she was subjected to were unsuitable for her, I encouraged her to undertake the journey. She accomplished it happily, but the catamenia appeared as soon as she arrived, and did not leave off until the sixth day. I then gave Ferr. met. 24, three globules in half a tumbler of water, to be taken until the following day.
The effect was favourable, no loss, only some pinchings in the abdomen and small of the back. I continued the Ferr. met.
The third day there occurred pains in the stomach and two bilious motions ; the liver was tender, pulse 84. I gave internally Ars. 12, but as the pains in the stomach went off whilst the diarrhoea increased, I had recourse to Verat., and the symptoms subsided, the pulse falling to 72.
Then, that is to say, six days after the cessation of the catamenia, not two days as formerly, what the patient called a loss of blood, such as had occurred in England, recommenced. It was in reality a very profuse leucorrhoea, to which the name was very inappropriate, as it was of a chocolate-brown colour and very fetid.
Examination with the speculum showed the neck of the uterus swollen, but not ulcerated; 1 could only detect slight granulations and the presence of some viscid clots of a dark colour.
This case required a methodical and long-continued treatment; I reckoned that three months at least would be required, as well as great patience and perseverance on the part of patient and doctor.
I shall not go into details of the daily treatment, which lasted in fact three months and ended in complete cure. I will briefly pass it in review in order to come to and to recommend to you the remedy to which I attribute the greatest share in the successful results.
I had to treat a delicate impressionable woman, very much w eakened but very docile and punctual in taking her medicine.
During the first month, according as there were pains in the abdomen, with difficulty of passing water, or tumefaction of the liver, and a tendency to early recurrence of the catamenia, I had recourse to Bell. 12 and 200, Nux vom. 12, Sabin. 3 and <f>, lastly to Kreosot. 12, which removed a painful sensation of general swelling worse in the evening than in the morning.
I thus arrived at the return of the catamenia and the commencement of the second month, with a noteworthy amendment of the general health, but with little decrease of the discharge or alteration of its character. It usually reappeared one or two days after the cessation of the menstruation, at first slight and light coloured, but gradually very abundant and very dark, sometimes continuously, sometimes in gushes; I waited for it in order to employ a remedy which has never as far as I know been employed by us except in cases of true metrorrhagia, but with which I had made some successful trials, in consequence of remembering that it is employed by country people against various kinds of fluxes. This is the Thlaspi bursa pastoris, of which there are several varieties. This cruciferous plant is astringent and its use is unattended with danger even in considerable doses.
As soon as a discharge at first light coloured, hardly darker than pale cafe au lait, commenced to grow darker and more copious, I gave Thlasp. burs, past., 6 drops of the 6th dilution in 100 grammes of water, a spoonful every three hours.
The following day, which was the 19th of the month, the discharge grew pale and lessened, the following day it stopped, but the patient complained of colic and pinching in the stomach; the 21st, in spite of the medicine being continued, the pains in the stomach had ceased, the discharge had not returned; it was the same on the 23rd, but the liver became tender, with accompanying pains in the groins and right leg, and the following night, 23rd— 24th, was marked by increase of the pains, then bilious stools and general uneasiness ; the 24th, finding the tongue furred, the liver enlarged, the stomach tender and sunk, I had recourse to Merc, sol. 12.
The following day the discharge returned and the general state was less satisfactory; there was a sensation of fatigue with trembling and rigor.
I resolved not to have again recourse to Thlaspi before the following month, and to employ the interval until the next menstrual period in fortifying and giving tone generally and locally to the patient.
I made her take cold drinks every morning and inject cold water, also to take Secale corn. 3 and <p, one centigramme in 100 grammes of water.
These remedies appeared to me necessary, the cervix was swollen and soft, there was some slight difficulty in passing water, the introduction of the injecting tube was painful, the strength was failing, and the pain, which from the right groin had passed into the left, did not allow of carriage exercise.
In the end I obtained a marked amendment, and several times the leueorrhoeal discharge diminished sensibly, and even stopped for some time, but it again became more copious, deeper coloured, and more fetid than ever as the catamenia approached.
During the fortnight previous to this appearance I gave, without paying attention to the discharge, first Ferr. met. in the first trituration, then China <fi, 30 drops in 300 grammes of water, a spoonful every hour.
The catamenial discharge was copious and dark coloured. Two days after its cessation, on the appearance of a discharge resembling the washings of meat, and in spite of the sensitiveness of the liver and some pains in the right leg down to the foot, I prescribed Thlaspi <p, 10 drops in 200 grammes of water.
The discharge immediately diminished and stopped after three days.
I continued the Thlaspi in the 6th dilution this time and persisted in its use; at the end of ten days, reckoning from the cessation of the catamenia, the patient, who had not quitted her house in the evening for more than two months, felt so well that she ventured to dine out.
"With the exception of an interruption of forty-eight hours to give Argent, for fatigue of the voice, I insisted on the continuance of Thlaspi until the reappearance of the catamenia, only diminishing the frequency of the dose.
The catamenia came on at the accustomed time, but the discharge did not return and has not recurred for eight months. On the contrary, the lady has gained greatly in strength, and the good health she enjoys sets off her natural beauty.
[note By Db. Dudgeon.—With all deference to Dr. Rafinesque, whose treatment in this case was crowned with success, I would venture to differ from him in respect to his pathology of the disease here described. I do so with the more confidence, as I believe the patient was for some time under my own treatment. She had not a slight but a severe attack of icterus, with great pain and tenderness of the liver, and during all the three months I attended her she betrayed unmistakeable symptoms of congestion of and imperfect circulation through the liver. The metrorrhagia—for it was a real metrorrhagia and not at all like any leucorrhoaa I have ever seen—was evidently owing to a congested condition of the uterus, which again appeared to me to be a secondary effect of the congested condition of the liver. Whether the cure was due to the Thlaspi or to the change of climate and regimen, and the tonic treatment previous to the last catamenial period, I will leave to the reader's own judgment.]
Case 1.—A married lady, aged thirty years, experienced a tickling sensation in the bronchial tubes, which she believed to be the result of inhaling some irritating vapour from the atmosphere. The tickling caused a cough which, at first, was unattended with expectoration, but the tickling and inclination to cough did not subside as she anticipated, and the irritation of the mucous membrane increased until it settled into a chronic inflammation. She then began to expectorate a white, frothy mucus, attended with no pain except from severe paroxysms of coughing. At this stage the case came under our treatment. Our first prescription was Hepar sulph. 6th attenuation, in water, a table-spoonful twice a day. After two days there was a change in the expectoration, but the cough remained about the same, and she expectorated a yellowish, tough phlegm. Phosphorus 6th, a few drops in half a