Arum triphyllum

.................... Excessively cross and stubborn (Tub.). NERVOUS; CHILD PERSISTENTLY BORES INTO NOSE or picks at lips, the fingers or at one spot; until it is sore or bleeds. Acrid, fluent coryza. Raw, cracked lips (angles) (Psor.). Painfully raw, sore, inflamed mouth. Aphthæ. Raw sore throat; painful on clearing or coughing, yet grasps or wants to scratch it. Hay asthma. Stools like corn-meal. Uræmia. Voice hoarse, squeaky or breaks. Itching fingers and toes. Eruptions leave a brilliant red stain. Pemphigus. Impetigo contagiosa.

Over use of voice: TALKING. Singing. Cold, wet winds. Heat. Irritation. PAINFULLY SORE, RAW AND BURNING PARTS. ACRID DISCHARGES.

Mucous membranes: Mouth. THROAT. Larynx. Kidneys. Brain. Blood. Skin.

Complementary: Nit-ac. Related: Ars. Merc-c.

Arum triphyllum

Indian Turnip. Aracece.

Coryza ; acrid, fluent; nostrils raw.

Nose feels stopped up in spite of the watery discharge (compare. Am. c., Samb., Sinap. ) ; sneezing < at night.

Acrid, ichorous discharge, excoriating inside of nose, alse, and upper lip (Ars., Cepa).

Constant picking at the nose until it bleeds ; boring with the finger into the side of the nose.

Picks lips until they bleed ; corners of mouth sore, cracked, bleeding (with malignant tendency, Cund. ); bites nails until fingers bleed.

Patients pick and bore into the raiv bleeding sur- • faces though very painful ; scream with pain but keep up the boring (in diphtheria, scarlatina, typhoid).

Children refuse food and drink on account of soreness of mouth and throat (Mer.) ; are sleepless.

Saliva profuse, acrid, corrodes the mucous membrane; tongue and buccal cavity raw and bleeding.

Aphonia : complete, after exposure to northwest winds (Acon., Hep.) ; from singing (Arg. n., Caust., Phos., Sel.).

Clergyman’s sore throat; voice hoarse, uncertain, uncontrollable, changing continually; worse from talking, speaking or singing; orators, singers, actors.

Desquamation in large flakes, a second or third time, in scarlatina.

Typhoid scarlatina, with apathy, scanty or suppressed urine ; threatened ursemia.

The sore mouth and nose are guiding in malignant scarlatina and diphtheria.

Relations. — Useful : after Hep. and Nit. ac. in dry, hoarse, croupy cough ; after Caust. and Hep. in morning hoarseness and deafness, and in scarlatina.

Should not be given low or repeated often, as bad effects often follow. — Dr. L.

The higher potencies most prompt and effective.

Lecture XIX — Araceae — Arum triphyllum, Caladium, Dracontium and Pothos foetida

ARACEiE.

Thk order of plants which we shall study to-day is the Aracece, or, more correctly speaking, the Aroidece. The plants in this group all contain in their juices an acrid principle in more or less quantity. The Diffenbachia , when taken into the mouth, produces a frightful stomacace; the mouth is covered with a yellowish-white membrane; ulcers form upon the lips, tongue and fauces. This drug was proved by one of the students of this College. Since then it has been used in the treatment of violent forms of stomacace.

The members of this order which we shall consider are Arum biphyllum, Arum dracontium , Caladium seguinum, Pothos fcetida, Acorus (of which we know little or nothing), and Diffenbachia. ' Ailanthus, Ammonium causticum, Nitric acid.

[Arum triphyllum \ Muriatic acid, I^ycopodium.

I Selenium.

(^ Graphites.

Caladium Aracese < Dracontium Pothos fcetida Acorus v Diffenbachia Balsam of Peru.

Pix liquida.

Guaiacum.

I Eryodiction Californicum.

Arum Triphyixum.

The so-called " Jack in the pulpit " is the first drug in the order for our consideration. This remedy has an interesting history. Some twenty-five years ago there appeared an epidemic of scarlet fever, in the course of which nearly every case that was not promptly cured in the beginning died. The percentage of losses under homoeopathic as well as under other systems of treatment was truly frightful. The reason for this was that we had no remedy which covered the symptoms of the epidemic. In a poor family, living in a small street, there arace^:. 209 were five children sick with this epidemic form of scarlatina. The physician who was called to attend them had lost so many cases under the usual remedies that he thought it useless to have recourse to these. He thought it better to try something new. Arum triphyHum had only been experimented with to a certain degree, but still it had been known to produce certain symptoms which led him to the selection of the drug, which he administered in a low potency. All the cases recovered. It was afterward prescribed in other cases during the same epidemic, with marked success. From that time to this, Arum triphyllum has been looked upon as a valuable drug in the treatment of diphtheria, malignant forms of scarlet fever, and also other fevers having a typhoid form.

In scarlatina, we may use Arum triphyllum when there is an excoriating discharge from the nose and mouth, making the nose and upper lip raw and sore. The tongue swells; its papillae are large and red, giving it a rough feeling comparable to a cat's tongue. The throat is very sore, and the tonsils are much swollen. There is often a dry cough which hurts the child so much that he cringes under it and involuntarily puts the hands to the throat as if to modify the pain. The discharge from the mouth, also, makes the lips and surrounding parts of the face sore, cracked and bleeding, even the saliva itself being very acrid; scabs form; the child will not open his mouth. He is excitable and irritable in mind as well as in body. Thus, you see that Arum triphyllum is an exceedingly irritating drug. The child is restless, tosses about, is cross and sleepless at night. The eruption may come out very well and there may be double desquamation. At other times the rash is dark and imperfectly developed; the child picks and bores its fingers into its nose, or nervously picks at one spot till it bleeds. In mild cases, the urine may be very profuse; in severe cases the urine is greatly diminished and the appearance of profuse urination is a sign that the remedy is acting well. In very bad cases, however, those in which the malignancy shows itself in both the internal and external symptoms, you will find a perfect picture of uraemia. The child tosses about the bed unconscious, and has this involuntary picking at one spot or boring the finger into the nose; the urine is completely suppressed. The brain is very much irritated, as shown by the restless tossing about and the boring of the head into the pillow. In such a case, Arum triphyllum may save the patient, although, at the best, the case is an exceedingly doubtful one.

I have never seen inflammation of the brain yield to Arum triphyllum, unless some of these symptoms were present; either irritation about the throat, mouth, or nose, or else this peculiar picking or boring at the nose or at one spot till it bleeds. I think that as a rule it is indicated when the cerebral inflammation comes from the suppression of some violently acting poison, such as we find present in scarlatina or diphtheria. Nor would I think of giving Arum in uraemia if it arose in the course of ordinary Bright's disease. I do not think it can be the remedy unless the symptoms already referred to are present. Arum triphyllum has a marked effect upon the larynx. It produces a hoarseness which is characterized by a lack of control over the vocal cords. If the speaker attempts to raise his voice it suddenly goes up with a squeak. With this symptom you may use Arum in clergyman's sore throat, whether this affection be the result of overstraining the voice or of cold.

Possibly the remedy most similar to it in this hoarseness and uncertainty of voice is Graphites, which is excellent for singers who cannot control their vocal cords, and who develop hoarseness and cracked voice as soon as they begin to sing.

In Carbo veg. the voice is deep, failing when the endeavor is made to raise it.

Another remedy for this condition is Selenium. The patient gets hoarse as soon as he begins to sing.

Other remedies for the effects of increase of the voice are Arnica, Rhus tox., Causticum, Phosphorus and Natrum muriaticum. Now let us study for a few moments the analogues of Arum triphyllum. First of all we shall consider Nitric acid.

This was formerly the only remedy we had for scarlatina maligna. It has the excoriating discharge from the nose. No remedy has it more marked, not even Arum. The discharge from the nose makes the nostrils and lips sore. This is attended by great prostration. The throat is extremely sore and is covered with membrane of a diphtheritic character, either dark and offensive, or else yellowish-white. The mouth (whether the disease be diphtheria or scarlatina) is studded with ulcers, which appear principally on the inside of the cheeks, on the lips and on the borders of the tongue. This ulceration is accompanied by salivation, the saliva usually being watery and very acrid. The pulse frequently intermits every third or fifth beat, a very bad symptom. Nitric acid is also preferable to any of the other remedies in diphtheria with these excoriating discharges when the disease advances and affects the stomach (whether or not the membrane in these cases spreads to the stomach, I cannot say); when, with great prostration and membrane in the throat and nose, there is distress and uneasiness referred to the stomach, with total rejection of all food. Muriatic acid is another remedy in these malignant cases of scarlatina and diphtheria. Under this remedy there is the most intense prostration. The patient seems to have scarcely life enough to move. He is worse at about ten or eleven o'clock in the morning. The mouth is studded with deep ulcers having a dark or black base. They tend to perforate the parts on which they are situated. Muriatic acid frequently has the intermittent pulse of Nitric acid, but accompanying this symptom there are involuntary stool and urine. In addition to Nitric acid and Muriatic acid in cases having this dangerous group of symptoms you should think of Alcohol. Grauvogl, you may remember, found that diphtheritic membrane was dissolved and its growths destroyed by several substances, one of them being Alcohol. So this agent has become a remedy for diphtheria. Alcohol in the form of brandy and water tends not only to destroy the growth, but also aids in counteracting the terrible prostration. Lycopodium is similar to Arum triphyHum in scarlatina and in diphtheria. It has a similar nasal discharge, usually associated, however, with dull, throbbing headache at the root of the nose or over the eyes. The nose is so stuffed up that the child cannot breathe at night. The patient bores and picks at the nose just as under Arum triphyllum. But in the Lycopodium case the diphtheritic deposit travels from the right to the left side. The patient is always worse from sleep even after a short nap. He suddenly awakens from sleep, crying out as if frightened; nothing can be done to pacify him. He is irritable and peevish. In more advanced cases calling for Lycopodium, you will find the child unconscious and in a deep sleep. The lower jaw drops, the urine is scanty or even suppressed, and what does pass stains the bedding or clothing red and deposits a red sand. The breathing is rapid, rattling, with waving of the alse nasi and snoring. The mucous membrane of the throat is ulcerated and oedematous. Hvery symptom points to impending paralysis of the brain.

Ammonium causticum was first suggested by Dr. J. P. Dake as a remedy in diphtheria appearing in the nasal cavities, with a burning, excoriating discharge from the nose, and great prostration. The symptoms above mentioned led Dr. Dake to use the remedy in an epidemic which appeared in Nashville, Tennessee.

I^astly, let me mention Ailanthus. This drug is a member of the order of Simarubaceae. It is analogous to Quassia, Cedron, Brucia, etc., all of which are of bitter taste and have anti-malarial properties. Its history is as follows: Dr. P. P. Wells, of Brooklyn, had two cases of poisoning in children. From his statement of the symptoms, it would certainly seem that he had to treat malignant cases of scarlatina; but there being no such epidemic about at that time, he looked for other causes, and found that the little patients had been chewing the blossoms of the Ailanthus. This told him at once that the Ailanthus would probably become a remedy in scarlatina. He made provings of the drug, and found that they fully confirmed what he had already learned from these poisoning cases. Since then this remedy has been successfully used many times. A year ago I attended a boy with scarlatina. The child lay in a stupor with his mouth wide open. The throat was swollen, the nose stuffed up, and the slight rash that had appeared on the body was dark and mixed with bluish spots. I gave Lycopodium, without any benefit whatever. The child grew worse instead of better. I then thought of Ailanthus, and gave it in the sixth potency, with the result that the child was completely cured. I believe the patient would have died had it not been for the Ailanthus.

Ailanthus resembles Arum triphyllum in the acridity of the discharges. There are excoriating discharges from the mouth and nose, making the lips sore. We find a similar swelling of the throat, both inside and outside. So far as these superficial symptoms are concerned, the remedies are identical. But there is a great difference to be recognized in the other symptoms. The Ailanthus patient becomes drowsy and lies in a stupor, hence this drug is indicated when there is torpidity rather than the restless tossing about of Arum triphyllum. The Ailanthus rash comes out imperfectly; it is dark red or bluish, and is mixed with petechise.

Some little time ago, several members of the class asked me to speak of the remedies useful in diphtheria, and while I am on the subject of Aru?n and its analogues in this affection, I shall take the opportunity to comply with that request.

Baptisia tinctoria has long enjoyed a great reputation in typhoid fever. It has lately been used in diphtheria, and in scarlatina also when the child is very much prostrated and lies in a half-stupid state, almost like one intoxicated. The face is dark-red, and has a besotted look, and the discharges from the mouth and nose are horribly offensive, so much so, indeed, that one might suppose that gangrene of the affected parts had taken place.

Rhus tox. we find indicated in rather severe cases, when the membrane is dark in color and bloody saliva runs out of the mouth during sleep. These symptoms are associated with inflammation of the glands about the neck, of a dark erysipelatous hue.

Phytolacca decandra we find useful when, in the beginning of the disease, there are creepy chills and backache. The patient is weak, and feels faint when he sits up in bed. On looking into the throat you find it dark-red, almost purple. There is great burning in the throat, with aggravation from hot drinks.

Amygdala amara is indicated when there are sharp, lancinating pains in the swollen tonsils. The palate and fauces have a dark-red hue, and the patient is very much prostrated.

Naja tripudians is to be administered when there is impending paralysis of the heart. The patient is blue. He awakens from sleep gasping. The pulse is intermittent and thready. Dr. Preston, of Norristown, has been very successful with Naja when the symptoms I have mentioned were present.

Apis mellifica is indicated in diphtheria, when, from the very beginning, the child is greatly prostrated. He is feverish and drowsy at 3 p. m. The pulse ranges from 130 to 140, and is very weak. At first the throat has a varnished appearance as though the tonsils and fauces were coated with a glossy red varnish. The membrane forms on either tonsil, oftener on the right than on the left, and it is thick like wash-leather. The tongue is often swollen. If the child is old enough to talk to you, he will complain of a sensation of fulness in the throat, necessitating swallowing but making the act very difficult. The uvula, in fact the whole throat, is cedematous and swollen. The rima glottidis is swollen, red, and cedematous, making breathing difficult. In some of these cases the breath is very foetid, while in others it is not so in the least. In some cases a red rash appears over the body, greatly resembling that of scarlatina. The child is often thirstless in spite of the presence of fever.

Arsenicum album is called for in rather severe cases of diphtheria, when the throat is very much swollen both internally and externally, and the membrane has a dark hue and is very foetid. There is a thin, excoriating discharge from the nose. The throat is ©edematous, just as it is under Apis. The patient is restless, especially after midnight, and is greatly prostrated. The urine is scanty; the bowels are constipated, or else there is an offensive, watery diarrhoea. Natrum arsenicosum is the remedy when the throat is of a dark purplish hue, with great swelling and prostration, but without much pain.

Kali permanganatum is useful when the membrane is horribly offensive. The throat is oedematous, and there is a thin discharge from the nose; the chief characteristic of the drug is this extreme foetor.

Lachesis is called for when the membrane forms first on the left tonsil and spreads thence to the right. It is to be distinguished from other drugs which act in a similar manner by the fact that the symptoms are worse from empty swallowing, and are often relieved by eating or swallowing solid food. There is a constant feeling as of a lump on the left side; this descends with each act of deglutition, but returns again. Sometimes, on waking from sleep, there is a feeling as if there were needles in the throat, which create suffocation. When the tonsils are very much swollen, fluids are apt to return through the nose. The fauces are of a dark purplish color, and there is great prostration. The heart is weak in its action. There is aggravation after sleep, and the throat is sensitive to the slightest touch. Belladonna is not a prominent remedy in diphtheria. When you do give it in this disease, make sure that it is the remedy or you will lose valuable time. It may, however, be the remedy in the early stages when the violence of the attack calls for it, if there is congestion of the head before the membrane has formed.

Other frequently indicated remedies are Kali bichromicam , Iodine, Bromine, Mercurius biniodatus, Mercurins cyanalus, etc. Some of these I have already given you, and the others you will get in future lectures.

Jack-in-the-Pulpit Arum maculatum, Italicum, Dracontium, have the same action as the Triphyllum. They all contain an irritant poison, causing inflammation of mucous surfaces and destruction of tissue. Acridity is the keynote of the kind of action characteristic of Arum.

Worse, northwest wind; lying down.

Bores head in pillow. Headache from too warm clothing, from hot coffee.

Quivering of upper eyelids, especially left.

Soreness of nostrils. Acrid, excoriating discharge, producing raw sores. Nose obstructed; must breathe through mouth. Boring in the nose. Coryza; discharge blood-streaked, watery. Nose completely stopped, with fluent, acrid discharge. Hay-fever, with pain over root of nose. Large scabs high up on right side of nose. Face feels chapped, as if from cold wind; feels hot. Constant picking at nose until it bleeds.

Raw feeling at roof and palate. Lips and soft palate sore and burning. Lips chapped and burning. Corners of mouth sore and cracked. Tongue red, sore; whole mouth raw. Picking lips until they bleed. Saliva profuse, acrid, corroding.

Swelling of sub-maxillary glands. Constricted and swollen; burns; raw. Constant hawking. Hoarseness. Expectoration of much mucus. Lungs feel sore.

Clergyman's sore throat. Voice uncertain, uncontrollable. Worse, talking, singing.

Scarlet rash; raw, bloody surfaces anywhere. Impetigo contagiosa.

Compare: Ammon carb; Ailanthus; Cepa. Antidotes: Buttermilk; Acet ac; Puls.

Third to thirtieth potency.

Arum Triphyllum (Indian Turnip)

Generalities: Many boys have wandered in the low grounds where this wild turnip grows, and have taken a nip out of it, and probably remember the sensations in the mouth that they received at that time.

I distinctly remember making an endeavor to enjoy a piece of wild turnip. The tingling that is left in the lips and tongue and from the throat to the end of the nose, and wherever sentient nerves come to the surface, is astonishing. The prickling and tingling is painful. It is a sensation that cannot be let alone. It requires a continued manipulation, and from this we gather the sensations that must be present in children when they are suffering from acute diseases and this remedy is indicated.

For, in spite of the rawness and bleeding and smarting of the parts, they will insist on pinching and scratching and picking the lips and pressing around the mouth and boring into the nose. It has been a guiding feature in acute diseases, scarlet fever, many throat affections, diseases that take on a low type, such as continued fever and eruptive fevers.

Among other complaints, sore throats, zymotic affections, delirium and excitement, even maniacal manifestations. It is manifested to a great extent in these associated symptoms. It must be that there is in the nose and lips painful tingling that the patient persists in boring the fingers into the nose.

Manipulating and pinching the lips, picking the lips. It is altogether a different symptom that occurs in delirium of a low, muttering type, which we call carphologia, picking the bed clothes, picking all the time, picking and handling the clothing, a busy, low form of muttering, must be doing something all the time groping around with the fingers and feeling for something. This is the carphologia and it is a mental symptom. While "picking the lips" is given under the "mental" symptoms in the repertory, it is not intended to mean that it is a mental symptom like carphologia.

Now, you will find two expressions in the repertory, and it is necessary to have two - the one is that "the nose itches," and the other is "he rubs the nose,"

he does something; that is what an individual would do if his nose itched. One's mind is not always directed towards the two-one is a direct and the other is an indirect expression. This remedy has not been sufficiently proved to bring out the nature of its chronic manifestations. It has undoubtedly something of that kind, but it has been used in a limited way among acute affections of a zymotic character. It has not been used to any great extent for chronic sick headaches, but it has cured some headaches that are worse in the heat, worse in a warm room and from warm clothing, worse from becoming warm, worse from wrapping up the body.

Heat in the head, determination of blood to the head. It has also cured eruptions upon the scalp like eczema.

Nose: It has also been found useful in catarrhal affections of the nose, eyes and lids. About the nose its affections have been mostly of the acute kind. It has most dreadful coryza, The nose is stopped up, and more stopped up on the left side. Must breathe through the mouth. Sneezing worse during the night; fluent acrid coryza. The discharge of saliva flowing over the lips produces rawness, smarting and burning of the mucous membranes, and the lips, bleed. The fluid from the nose as it flows over the skin leaves red streaks.

"Acrid ichorous discharge excoriating the inside of the nose, the alae and upper lip."

That is expressive and occurs in diphtheria; in various forms of sore throat, in scarlet fever, when this remedy is indicated.

Inflammation of the tongue, with acrid discharge from the nose. Inflammation of the root of the tongue, of the throat and soft palate, of the tonsils. The glands of the neck are swollen. This inflammatory condition is followed by paralytic weakness, making it impossible for him to swallow liquids or food, and when the mouth forces food into the pharynx the oesophagus refuses to operate, and then fluids and liquids are forced up into the nose and run out of the nose.

This has been clinically observed many times in diphtheria and sore throats. The sneezing is like an ordinary coryza, with repeated chills over the body, and aching in the bones as if the bones would break, like Nux, Eupator., Arn., Rhus, Bry. and Ars., that have aching all over during ''cold.'' This is one of the most striking medicines as an illustration of the keynote system, that is, with those who prescribe on one symptom and give this medicine whenever the patient bores his nose or picks his lips, notwithstanding that Cina bores the nose and picks the lips.

Cina has more of the congestive and nerve symptoms. The nostrils are really so sore from the acridity of the fluids inside of the nose that it feels as if the nostrils were filled with fire. This is the language of the patients who narrate their symptoms in an Arum triphyllum case.

They come into the office with a sore, raw nose, and it tingles and tickles and he cannot let it alone. Fluids run down over the lip and excoriate. The glands of the neck are often enlarged. When he takes cold in one nose there is soreness of the neck and parotid gland.

Desire to bore into the nose. This boring into the side of the nose is another symptom and differs from the one "boring the nose."

You will see children boring in the nose, inside of nose. it is an inflammation of the nasal duct, the duct that leads from the eye to the nose, and accompanied by a discharge of tears over the cheeks, with the tickling that extends up there which they cannot reach, but they undertake to reach it.

Can hardly talk on account of phlegm in the back part of the nose. He talks through the nose. The nose is filled with mucus and there is great tumefaction of all the mucous membranes; which gives him a nasal tone.

"Swollen, bloated face."

If you observe the nose and face you will be surprised to see that so much of the trouble is on the left side of the face, left nostril, left lachrymal duct, etc.

Mouth: There is bleeding of the lips, upper and lower. The under lip especially is denuded and drops of blood stand upon it, and the patient is constantly picking and pinching the lips, and when you request of the little one to stop it or take his hands away he yells with a sort of sepulchral yell.

"Children will often pick and bore into raw surfaces, though it gives them pain and they scream with it, but they keep on boring." That is a striking symptom. Fluids make the lips raw and then this tickling comes on and he cannot let it alone, ho must keep at it. "Appearance of raw bleeding surfaces on the lips, buccal cavity, nose, etc."

Great itching tingling describes it. In typhoid, where you would hardly expect much swelling of the parotid, these glands are enlarged. In diphtheria, scarlet fever and sore throat enlargement of the salivary glands.

This inflammatory condition with soreness and swelling of these glands; the glands are hard and tender to the touch. The tongue is red, the papillae elevated; the tongue appears to be almost denuded. It is raw and bleeding, sometimes does bleed in a few places, and sometimes, after this has gone on for a few days, when the tongue is projected it looks like a big red straw berry, and for that reason has been called "Strawberry tongue."

"Tongue cracked, bleeding, burning, painful; smarting on tongue and fauces."

Putrid odor from the mouth. Mouth foul, so sore that he was unwilling to drink. All this points to tingling and raw condition of the buccal cavity far back into the throat.

If you look into the buccal cavity you will see the parts raw, denuded and bleeding. Excessive flow of saliva, which is acrid. Mouth burns and is sore. Cries when anything is offered. Buccal cavity covered with diphtheritic ulcers, also with aphthous patches, which cover the whole mouth and tongue.

It says "stinging," but it is a painful tingling, stinging like the sting of a bee, stinging pains in the throat, and the parts are ulcerated, raw and bleed.

Stools: It has a diarrhoea such as occurs in idiopathic typhoid. If you have ever seen the yellow corn-meal mush when it is dropped on a plate, it has the appearance of the typhoid yellow stools. When this medicine is suitable diarrhoea is yellow like corn-meal; frequent, faecal, thin, mushy, yellow, is the description of this typhoid stool.

There are other times that the stool is dark brown, watery, thin. As is usual, the faeces are acrid. The thin faeces escape from the anus and keep the parts raw and burning. With other complaints, in typhoid especially, in the groin where the thigh bends upon the abdomen an excoriation takes place with acrid moisture. Again, we notice rawness over the coccyx. A moisture and rawness from acrid fluid in the posterior part of the fissure back of the anus so that over the coccyx and back of the anus there is rawness and acrid moisture.

Voice: The voice comes in for art extensive part of the trouble. It has been found especially to relate to singers and public speakers. At times when a lawyer has had a long case and he is making a final effort, and has been speaking three or four hours, and while in a sweat has got into a draft or gone out, he finds himself hoarse and cannot finish Ids speech, a dose of Arum triph. will enable him to go on with his speech in a clear voice.

If clears up the hoarseness. In public speakers and singers who have been compelled to strain the voice and have taken a little cold and the voice is hoarse after prolonged exercise; this is the most striking feature of the Arum triph. voice.

"Voice hoarse; from over-exertion of the voice is speaking or singing."

"Voice uncertain, uncontrollable, changing continually, now deep, now hoarse, etc." It manifests itself in this way. A person starts in a certain pitch and he cannot talk to you, but he tries another pitch and can talk. It is a queer thing that on certain notes they are voiceless, which shows that there is an irregular and patchy inflammation of the vocal cords; it is not a uniform inflammation or the voice would be uniformly affected.

"Clergyman's sore throat," is not a good expression, because it is clergyman's hoarseness that is meant; hoarseness and rawness of the throat of public speakers when talking. Of course you would say any voice that is hoarse is aggravated when talking, but it is not always so.

The Rhus hoarseness carries with it its characteristic relief from motion, and the use of the voice is motion of the larynx.

When the Rhus patient commences to use the voice he finds that he is hoarse, but after using the voice a little it loosens up, becomes freer, or, in other words, it is better from motion. This may be so either in acute or chronic hoarseness. Now, in this remedy as in Phosphorus, the voice is ameliorated from clearing the vocal cords of a little mucus. It is not so in Rhus tox., for it is a weakness and paralysis from cold. It is well known under Rhus tox. that the tendons and muscles that are rheumatic become weak, they are stiff on beginning to move and are ameliorated when they are warmed up; so it is with the voice.

Chest: Now, in the chest there is burning and rawness when coughing; this extends to the pit of the stomach.

"Raw feeling in chest."

"Lungs feel sore."

"Soreness in l. lung."

You will notice that many times patients and provers state sufferings are in the lungs, which may not really be the region affected. Most likely from what is known of other symptoms this burning is in the trachea, although it says in the lungs.

This remedy does have burning in the trachea, the whole length of it, during an attack of coughing, and burning in the larger branches of the bronchial tubes. The catarrhal state is largely confined to these parts, the trachea and bronchi, but this medicine has cured pneumonia It has been found useful as a palliative in phthisis. It is used in crude form among the farmers as a domestic medicine for coughs and colds and as a palliative, in consumption. In many of the farm houses you will find the wild turnip hung up in strings like heads to be dried and, grated and used with sugar and cream.

I mentioned the fact that it seems to favor the left side of the head, the left nostril, the left side of the face. It also prefers the left chest and the left lung. It has soreness in the left side of the chest and left arm. it has a sensation of fullness in the thorax and soreness extending down and involving the left lung.

Here is a clinical picture of fever:

"Typhoid forms of fever; picking ends of fingers and dry lips till they bleed, etc."

In most of these complaints the urine is very scanty and is sometimes suppressed. You will very commonly note a good action of this medicine in these complaints by its immediately starting up a copious flow of urine. It is a sign of relief.

It has upon the skin all the scarlet rash that you would expect to find in scarlet fever, and it has also the typhoid petechiae.