Bryonia alba

Lecture XXIX — Bryonia alba

i. Blood.

2. Serous Membranes.

3. Muscles.

4. Skin.

Bryonia. <j a. Rash ; Measles.

b. Scarlatina.

c. Suppressed eruptions.

J 5. Mucous membranes.

^ 6. Organs.

There are three species of Bryonia, but so nearly identical are they that Allen has classed them under one heading in his Encyclopaedia. Bryonia alba is one of the oldest remedies in the homoeopathic materia medica, and is one of the best proved. It grows plentifully in England and on the continent in Europe. The tincture is prepared from the roots. It is a polychrest, suitable to many kinds of disease. To give you all its symptoms, even all its characteristic symptoms, would take two or three hours of steady hard work. I will endeavor in the hour before us to explain the action of Bryonia so far that you may be able to apply the drug, and, as I have said before, supply the deficiencies at leisure.

We find Bryonia indicated first of all in changes in the blood ; in changes affecting its quantity, its quality and its circulation. For example, it is indicated in febrile conditions ; in fevers of an intermitting type, although not frequently ; in those of a remitting type, very often ; sometimes, too, in synochal fever ; and also in rheumatic, gastric, bilious, traumatic and typhoid fevers, in all of which, gastric symptoms are prominent. The symptoms which characterize its fevers are in general these : there in an increased action of the heart, giving rise to a frequent hard tense pulse, very much as you find under Aconite, There is actually an increase in the force and power of the heart's action. This action is augmented by any movement of the body, consequently the patient is anxious to keep perfectly quiet. Then you find that there is almost always intense headache with these fevers. This is usually of a dull throbbing character or there may be sharp stabbing pains in the head. This is almost always associated with sharp pains in or over the eyes. All of these parts are exquisitely sensitive to the least motion. The patient will avoid moving the eyes, for instance, because it aggravates the pain. The least attempt to raise the head from the pillow causes a feeling of faintness and na sea. The mouth is very dry and the tongue is coated in the milder forms of fever as, for instance, in the synochal fever or in the light gastric type of fever. The coating on the tongue is white, and is especially marked down the middle. The edges of the tongue may be perfectly clean. As the fever grows in intensity, it approaches more a typhoid type. Bilious symptoms predominate. The white tongue becomes yellowish and is associated with a decidedly bitter taste in the mouth. There are splitting headache, tenderness over the epigastrium, with stitches, soreness, or tenderness in the right hypochondrium. As the typhoid symptoms increase, the tongue becomes more and more dry, but still maintains its coating. If the fever is of an intermittent type, you will always find the chill mixed with heat; that is, during the chill the head is hot, the cheeks are a deep red and there is a decided thirst, which is generally for large quantities of water at long intervals. In some cases it may be a continuous thirst. The pulse is hard, frequent^ and tense. The sweat is provoked by the least exertion and has either a sour or an oily odor.

In typhoid fever, Bryonia is indicated in the early stages and by the following symptoms : there is some confusion of the mind ; the sensorium is depressed but there are no perversions of the senses. During sleep there is delirium, which is usually of a mild character. On closing his eyes for sleep, he thinks he sees persons who are not present. On opening them, he is surprised to find that he is mistaken. Sometimes this delirium is accompanied or preceded by irritability. The speech is hasty, as you find under Belladonna. As the disease increases, some little heaviness almost approaching stupor accompanies sleep. The patient has dreams, which have for their subject the occupation of the day. Frequently with this delirium, the patient suffers from an agonizing headache. This is usually frontal. If the patient is able to describe it to you, he will tell you that his head feels as if it would burst. No better term than " splitting headache " could be used to describe it. It is congestive in its character. The face is usually flushed and of a deep red color. This is intensified like all BRYONIA AI/BA. 2QI the other symptoms of the drug, by any motion of the head, and is often accompanied by nose-bleed. The epistaxis is particularly liable to come on at three or four o'clock in the morning, and is frequently preceded by a sense of fulness in the head. In very severe cases, you will notice that the patient puts his hand to his head as if there were some pain there, and his face is expressive of pain. Yet so stupid is he, that he makes no complaint other than that expressed by these automatic movements. Another symptom to be noted in these typhoid fevers, is the dryness of the mucous membranes, especially those of the mouth and stomach. This is the result of deficient secretion. In no case is the condition more apparent than in typhoid states. The mouth is dry, as I have already intimated, and yet there may be no thirst. If there is thirst it seems to have the character I mentioned in speaking of intermittent fever. The patient drinks large quantities but not very frequently. After drinking water or while attempting to sit up, the patient has a deathly nauseated feeling and sometimes even vomits. At other times he complains of a heavy pressure in the stomach, as if a stone were lying there. This symptom is no doubt due to the same pathological condition we found in the mucous membrane of the mouth. The secretion of gastric juice is deficient, consequently food lies undigested in the stomach. When B?yonia is called for the bowels are usually constipated. When they do move, the stools are large, hard and dry, and are either brown or black in color. They are expelled with difficult}' owing to the atony of the rectum. Sometimes in well-advanced cases of typhoid fever, you will find soft, mushy stools, calling for Bryonia. There is a symptom which sometimes accompanies typhoid fever at about the end of the first week of the fully developed fever, and that is a form of delirium in which the patient expresses a continual " desire to go home." He imagines that he is not at home and longs to be taken there in order to be properly cared for. This symptom is a strong indication for Bryonia, and frequently disappears after two or three doses of the remedy. In these febrile conditions, it is necessary to place Bryonia in its proper relations with its concordant remedies. First of all Aconite. Aconite bears an intimate relation to Bryonia in all these types of fever except gastric, intermittent and typhoid fevers. Aconite has not in its totality any special relation to any of these, however incorrectly it may be given to lessen the temperature. The symptomatology of Aconite is opposed in every respect to that of typhoid fever. In gastric fever, it may be given in the beginning when there is the full pulse, hot and dry skin and restlessness, indicating that drug ; but as the fever advances, it is then not indicated unless there are bilious complications. Then it is an all-sufficient remedy. The distinctions that you are to make between Aconite and Bryonia are as follows: in the first place, they hold the relation of Aconite and Bryonia and not Bryonia and Aconite; that is to say, Aconite is given earlier in the case than is Bryonia. Aconite suits the hyperemia, the congestion or even the chill which precedes an inflammatory fever. Bryonia is indicated later when Aconite fails. The mental symptoms of the two drugs are so distinct that you ought not to confuse them. Aconite demands that the mind be excited, that the patient be restless, tossing about the bed, full of fears. He imagines that he is going to die. The Bryonia patient may suffer just as much as the one to whom you would give Aconite, but he is perfectly quiet. He is quiet because motion aggravates his symptoms. Early in typhoid fever, and sometimes in rheumatic fever, you may have Bryonia indicated by this symptom: the patient is restless and tosses about the bed impelled by nervousness, and yet he is made worse by the motion. If there is anxiety in Bryoyiia it assumes more the form of apprehension ; he fears that he will not have the wherewithal to live.

Still another remedy to be thought of in connection with Bryonia in these fevers is Belladonna, and particularly in the beginning of typhoid fever. Now there is really nothing in the symptomatology of Belladonna which would call for it in a well-advanced case of typhoid type of fever. Only in the beginning could you confuse it with Bryonia. In the first place it has erethism. Here you distinguish it by its delirium, which is of a violent character. The patient jerks his limbs and starts during sleep. He springs up from sleep in affright. As soon as he closes his eyes, he sees all sorts of objects and people, which disappear as soon as the eyes are opened. Belladonna, then, has more cerebral erethism, and more violence in its delirium than has Bryonia. With the Belladonna headache there are throbbing pains, and the patient may be obliged to sit up rather than keep perfectly quiet in order to obtain relief.

Another remedy to be compared with Bryonia is Rhus tox. This is often indicated in typhoid fever. You all know the historic fact that Hahnemann, during one of the war-epidemics of typhus, cured many cases with these two remedies. Since the days of Hahnemann, this use of these remedies has become universal. Remember, however, that they are not specifics. Each epidemic may so change in character as to require other remedies. Rhus tox. is indicated, when there is marked restlessness. The patient, first lying on one side, changes to the other. For a few moments, he feels better in his new position. Then he begins to ache and back he turns again. Like Bryonia, it has nose-bleed, when nose-bleed relieves the patient's symptoms, and the headache I described to you last month as " a sensation as though a board were strapped tightly across the forehead." There are rheumatic aching pains through the joints and muscles of the limbs. The tongue differs from that of Bryonia. It is brown and dry and even cracked, and has a red tip, also an excellent indication for Sulphur. With Rhus tox., there is frequently diarrhoea from the very beginning. Bryonia usually has constipation.

I just referred to the symptom under Belladonna—"the patient sees persons and objects on closing the eyes; these disappear as soon as the eyes are opened." Both Calcarea ostrearum and Cinchona have this symptom. Under the latter remedy, however, it does not occur in typhoid fever, but after haemorrhage.

Next, I wish to talk about the action of Bryonia on serous membranes. Bryonia acts powerfully on these, producing inflammation. Hence we are called upon to prescribe it when the meninges of the brain and .spinal cord, the pleurae and the peritoneum, and the synovial membranes are inflamed. The indications for Bryonia in these serous inflammations are particularly to be looked for after exudation has taken place. There are sharp stitching pains, worse from any motion. The fever may still be high or it may have been partially subdued by the remedy which preceded.

Comparing Aconite with Bryonia once more, you will see the same rule applicable here as before; Bryonia is indicated after and not before Aconite. Take for purpose of illustration a typical case of pleurisy. In the beginning of the disease when fever is high you select Aconite, but just as soon as the fever commences to decrease, and effusion begins, as indicated by the friction sounds, Aconite ceases to be of any benefit and Bryonia comes in as an all-sufficient remedy. It is customary with some physicians to give Aconite for the fever and Bryonia for the pleuritic trouble. But this is useless. Bryonia is adapted to the whole case. It has not the same restlessness which demands Aconite. The patient is quiet and is full of pain. He lies on the affected side. Why ? Because by the pressure thus exerted on the ribs, he moves the affected parts less than he would were he lying on the sound side.

When the meninges of the brain are affected, Bryonia is a valuable drug, but here, except in some rare cases, it follows Belladonna rather than Aconite. Belladonna ceases to be the remedy in meningitis, whether tubercular or otherwise, when effusion within the ventricles or beneath the membranes commences. It then gives place to Sulphur in some cases, Apis in others, and Bryonia in still others. Bryonia is indicated when meningitis follows the suppression of some eruption, as that of scarlatina or measles. The child's face is pale, or else it is red and pale alternately, the tongue white. The child screams out suddenly as if it were in great pain, which it really is. These pains are of a sharp lancinating character and are especially manifested on moving the patient. There is marked squinting with one or both eyes. The bowels are usually constipated, the abdomen distended and the child has well-marked sensorial depression which seems to border on stupor. If you arouse the child and offer him drink, he takes it impetuously or hastily, just as under Belladonna. The latter remedy has more rolling of the head.

For the sake of convenience we shall next study the catarrhs of Bryonia and the effects of the drug on the lung structure. We find Bryonia indicated in nasal catarrh when there is either great dryness of the mucous membrane of the nose, with hoarseness, sneezing, or more frequently, when the discharge is thick and yellow. It is also indicated when the discharge has been of the character just indicated and has been suddenly suppressed. As a result, there is dull throbbing headache just over the frontal sinuses. Bryonia, however, is not often indicated in catarrhs without some stomach and bowel symptoms. The treatment of colds is a severe test of the skill of a physician. If you can successfully treat them, you must understand homoeopathy well. They are the most difficult class of cases we have to contend with. There are two reasons for this. One is that the patients are constantly exposed, and the other is that they are not watched sufficiently closely. If you are given the opportunity to watch the cases carefully, so that you may prescribe as the indications change, you will cure promptly. Lachesis is also useful for suppressed coryza. But it has not so marked an aggravation from motion; nor has it the yellow discharge. Aconite should be given in cases where the suppression is due to dry cold winds, and there is red face, fever, etc. China comes in with headache worse from the least draught of air and better from pressure. We may also use Bryonia in pneumonia. The type of the disease in which it is indicated is in the true croupous form. Just as we found Bryonia indicated in pleurisy with effusion, so is it of use in pneumonia after the croupous exudation has taken place. Usually when it is called for there is also some pleuritis, hence it is applicable to pleuropneumonia. It is not indicated in the beginning of the disease because the exudation does not occur in that stage. It is indicated after Aconite , with the following easily understood condition. The fever still continues, but the skin is not so hot, the face so red and the patient so restless as when Aconite was indicated. The patient is more pacific, and his face and whole demeanor are expressive of anxiety. I would have you discriminate between this condition and that calling for Aconite. It is not so much the mental anxiety that Aconite pictures as it is an expression of pulmonary oppression. That you must remember. The cough which under Aconite was of a dry teasing character, with frothy sputa, perhaps still remains troublesome, but it is looser and more moist. There is very little expectoration yet, but what little there is, is either yellowish or streaked with blood. Owing to the accompanying inflammation of the pleura, sharp pleuritic stitches are felt in the chest. They are worse on the left side. The patient complains of heavy pressure just over the sternum. The pulse is full, hard and tense. The urine is dark-red and scanty.

Still another remedy that ought to be thought of along with Bryonia in pneumonia is Antimonium tartaricum. It is indicated in pneumonia that begins as a bronchitis and extends downward. It is especially suited to cases that begin on the right side, and that have these sharp stitching pains, high fever, great oppression of the chest, as in Bryonia. But it is called for more in catarrhal than in croupous pneumonia. Mucous rales are heard distinctly in the chest. The colds of Bryonia if they begin in the nose tend downward.

Several remedies other than Bryonia have these pains in the chestwalls. Gaultheria has pleurodynia, with pain in the anterior mediastinum.

Ranunculus bulbosus is decidedly the best remedy for intercostal rheumatism; it has sharp, stitching pains, and a sore spot in the chest, and these are worse from any motion (even breathing), pressure, or change of temperature. The dyspnoea in these cases is sometimes distressing.

Arnica is sometimes of use when the sore and bruised feeling of the chest predominates.

Rhus radicans is called for in pleurodynia when the pains shoot into the shoulder.

Senega acts best in fat persons of lax fibre. It is useful in cold with stitches, soreness in the thoracic walls, sensation of tightness, and much mucus in the chest. There is hoarseness; the throat is so dry and sensitive that it hurts the patient to talk; the cough often ends with sneezing.

Rumex crispus has sharp, stitching or stinging pains through the left lung; it is indicated more in the early stages of phthisis. When the patient turns the left side feels sore.

Asclepias tuberosa has sharp stitches through the lower part of the left chest, worse from motion. Kali carb. has stitches irrespective of motion, worse 2 or 3 A. m.

Trifolium pratense has hoarseness and choking spells at night with the cough. The neck is stiff; there are cramps in the sterno-cleidomastoid muscles which are relieved by heat and friction. Actea racemosa has pleurodynia; worse on the right side, especially in nervous women.

In bronchitis, Bryonia is indicated with this same pressure over the sternum; the dyspnoea is great; the cough is dry, and seems to start from the stomach. Bursting pain in the head with every cough. Sometimes a little tenacious blood-streaked sputum is raised. The cough is worse after a meal, when it may even end in vomiting. During the cough the patient presses his hand against his side to relieve the stitching pain. The same symptoms will indicate this remedy in whooping cough. The child coughs immediately after a meal, vomits what it has eaten, then returns to the table.

Returning now to the action of Bryonia on the serous membranes, we find it producing synovitis. The affected joint is pale-red and tense. There is, of course, effusion into the synovial sac. There are sharp, stitching pains, aggravated by any motion. Bryonia is indicated in these cases whether the synovitis be of rheumatic or traumatic origin.

The nearest concordant remedy to Bryonia here is Apis, which is an excellent remedy for synovitis, particularly of the knee-joint. Sharp, lancinating, and stinging pains, and effusions into the joint, are further indications for the remedy. Apis seems to be preferable to Bryonia when this synovitis is of scrofulous origin, or at least appears in a scrofulous constitution. Apis also has another kind of inflammation, which ends in the thickening of the serous sac and of the tissues and cartilages about the joints, giving you the well-known white swelling.

You should also remember Sulphur in these cases. This remedy supplements Bryonia and Apis, and urges them on when they fail to do their work.

We come next to the study of Bryonia in its action on the muscular system. It is one of the few drugs which produce a positive inflammation of the muscular substance; consequently you expect to find the drug of use in muscular rheumatism. The muscles are sore to the touch, and at times swollen, and, as you might expect, there is aggravation of the pains from the slightest motion. Actea racemosa also acts on the muscular substance itself.

Bryonia may also be indicated in articular rheumatism. We find that the fever is not very violent, and the pains and swelling either shift not at all or else very slowly. The local inflammation is violent; that is characteristic of Bryonia. The parts are very hot, and darkor pale-red. The pulse in these cases is full and strong, and the tongue is either uniformly white or, more characteristically, dry and white down the centre. The bowels are constipated. It is needless for me to say that the pains are worse from motion.

The difference between Bryonia and Rhus tox. is principally this: Rhus is suitable for rheumatism after exposure to wet, especially when one is overheated and perspiring. Then, too, the Rhus patient finds relief from moving about. Rhus attacks the fibrous tissues, the sheaths of the muscles, Bryonia the muscular tissue itself. The difference between Ledum and Bryonia may be described in this way: Ledum is useful for rheumatic or gouty inflammation of the great toe; instead of tending to copious effusion the effusion is scanty, and tends to harden into nodosities. In hot swelling of the hip and shoulder joints, Ledum should be remembered as more successful than Bryonia.

Actea spicata has a special affinity for the smaller joints. It has this characteristic: the patient goes out feeling tolerably comfortable, but as he walks the joints ache and even swell.

Viola odorata has a specific action on the right wrist. Caulophylhim is especially suited to rheumatism of the phalangeal and metacarpal joints, particularly in females.

Sabina also affects the small joints; gouty nodes; pains worse in a warm room.

In Colchicum we have marked aggravation in the evening; the affected joints are swollen and dark red. It is especially useful in weak debilitated persons, or in those who, despite local rheumatic inflammation, exhibit general symptoms of torpor. The stomach is generally affected; nausea when smelling food. The urine is scanty and red, and burns in passing along the urethra. The pains are of a tearing or jerking character, and appear as if in the periosteum. The pains are superficial in summer and deep in winter. In metastasis of rheumatism to the heart, both remedies are to be studied. Bryonia has great oppression under the sternum, worse from motion; sharp stitches in the cardiac region, pericardial effusion, with strong pulse. Colchicum has pericardial effusion, fulness and oppression while lying on the left side, compelling him to turn over. The pulse is small, weak, and accelerated. The Colchicum pains appear about the neck and shoulders, or in a small part of the body at a time, and then shift quickly.

Guaiacum is useful in chronic forms of rheumatism when the joints have become distorted by the concretions. It is also indicated in pleurisy during the second stage of phthisis with muco-purulent sputum.

Arctium lappa may also be compared with Bryonia in rheumatism. It cures soreness of the muscles, dull pains, all worse from motion; high-colored urine. All the provers were so weary and sleepy, they could not work.

Next we shall study the alimentary canal. We have already spoken of Bryonia here so frequently that its symptoms require but a passing notice. There are the dryness of the mucous lining throughout, the white coating of the tongue, the characteristic thirst, a feeling as though a stone or heavy weight were lying clogged in the stomach, the hard, dry, brown stool, passed with difficulty owing to the hardness of the faecal matter, atony of the rectum, and intolerance of vegetable food. The symptoms are worse in summer. It seems that the Bryonia patient cannot tolerate the heat of the sun.

The liver also is affected. We find it congested, or even inflamed. The gastric symptoms just mentioned complicate the case. The peritoneum covering the liver is inflamed, consequently there are sharp stitches in the right hypochondrium, worse from any motion and better when lying on the right side. In jaundice from duodenal catarrh, you may give Bryonia, especially when the trouble has been brought on by a fit of anger. Although the patient appears hot, he complains of feeling chilly.

Chelidonium is an admirable remedy for symptoms very similar to those just enumerated. Sharp pains in the region of the liver, shooting in every direction, up into the chest, down into the abdomen; well-marked pain under the scapula, even going through the chest like a rivet; and diarrhoea with either clay-colored or yellowish stools. It differs from Bryonia particularly in the character of the stool, and the peculiar pain under the scapula.

Bryonia is also similar to Kali carb.

, which is indicated in bilious affections when there are these sharp pains in the right hypochondrium, shooting up into the chest; often there is sharp pain, coming from the lower lobe of the right lung. The difference between these pains and those of Bryonia is that these are not necessarily made worse by motion.

Yucca filamentosa is an admirable remedy for biliousness, with pain going through the upper portion of the liver to the back. There is bad taste in the mouth; the stools are diarrhoeic and contain an excess of bile. A great deal of flatus passes by the rectum.

Chamomilla, like Bryonia, is indicated in biliousness following anger. With Bryonia there is apt to be chilliness with the anger; with Chamomilla the patient gets hot and sweats.

Berberis vulgaris also has sharp stitching pains in the region of the liver; but the pains shoot downward from the tenth rib to the umbilicus.

The bowels, I have said, are usually constipated under Bryonia, but in some cases the reverse condition obtains. Bryonia is indicated in diarrhoea when the attacks are provoked by indulgence in vegetable foods or stewed fruits, and also by getting overheated in the summer time. The movements are especially worse in the morning after rising and beginning to move around, thus distinguishing them from those of Sulphur and making them similar to the stools of Natrum sulph. In other cases, the patient is seized with sudden griping pains, doubling him up, accompanied by copious pasty stools. Sometimes the stools are dark green, from admixture of bile. They have the odor of old cheese.

The mental symptoms of Bryonia have been pretty thoroughly described to you in speaking of typhoid fever. I will merely say here that the patients are irritable and easily angered. This condition is present with the bilious symptoms, with the headache, and with the dyspepsia—in fact, it is characteristic of the remedy.

The headache of Bryonia, I have also told you, is worse from any motion; even a movement of the eyeballs aggravates the pain. The pain begins in the occiput, or else in the forehead, going back into the occiput. It is worse when awaking in the morning, after violent fits of anger, and from stooping. Its exciting causes are exposure to heat, especially moist, hot, foggy air; taking cold; debauchery and rheumatism. Headache from ironing.

The nearest remedy that we have to Bryonia here is Gelsemium, which has headache with this soreness of the eyes on moving them. Natrum mur. has a headache which feels like the beating of little hammers, with aggravation on moving the head and eyes.

With the occipital headache of Bryonia we should also compare Petroleum, which has throbbing occipital headache.

Juglans cathartica has occipital headache with pains of a sharp character.

Carbo veg. and Nux vomica have occipital pains with bilious attacks. On the external head, we find Bryonia developing an oily perspiration with a sour odor.

A similar symptom referred to the face is found under Natrum mur. Bryonia is a valuable remedy in diseases of the eyes, but not when the external coats of the eyes are affected. It is to be thought of for metastasis of rheumatism to the eyes. The pains are violent and shoot through the eyeball into the back of the head, or up toward the verex. They are aggravated by any motion of the head or eyes. There is also a sensation of tension as if the eyeballs had been put on a stretch. Antimonium tartaricum also has metastasis of rheumatism to the eyes. Now you know, from what I have said, that Bryoyiia is indicated in inflammation of the serous membranes with effusion. Bryonia ought, both symptomatically and pathologically, to be a remedy in glaucoma. The tension of the eyeball is greatly increased. Hot tears flow from the eyes. Photophobia and diminution of vision are present.

Bryonia is useful after operations on the eye when burning pains and vomiting follow.

The toothache of Bryonia is of a rheumatic origin and comes from cold. You will frequently find it occurring in teeth showing no signs of decay, which would lead to the conclusion that it is the nerve which is affected. More than one tooth may be involved and relief is momentarily obtained by firm pressure of the head against the pillow, or by the application of cold.

Toothache in children from decayed teeth, with relief from the application of cold water, finds its best remedy in Coffea. Kreosote has neuralgia of the face with burning pains increased by motion and by talking, especially in nervous, irritable persons whose teeth decay rapidly.

In aphthous sore mouth, Bryonia may be useful. The child seizes the nipple, but at once lets go and cries. When its mouth becomes moistened by the milk, however, it nurses well enough. We note here the characteristic dryness of the remedy.

The urine of Bryonia is dark, almost brownish red, without any deposit. This change in its appearance is due chiefly to excess of urochrome.

Bryonia has some action on the female genital organs. It is sometimes indicated in menstrual difficulties when the flow is dark red and profuse, but more especially is it useful when the normal flow has been suppressed and we have what has been termed vicarious menstruation.

Here you should compare Pulsatilla and Phosphorus, especially if the suppression of the flow produces haemoptysis or haematemesis. Senecio is to be thought of if the patient has cough with bloody expectoration.

Hamanielis, Ustilago and Millefolium come in for haematemesis. Bryonia is indicated in the lying-in chamber. For years I have been accustomed to using it for the so-called milk fever. I consider it indicated here more often than any other remedy because the symptoms of this affection are those of Bryonia. The fever is not very marked, there is tension of the breast with headache, tearing in the limbs and the patient is weary and wants to keep still. In threatening mammary abscess, Bryonia is indicated when there are sharp stitching pains, tension of the breast, and swelling of a pale red color.

In incipient mammary abscess you should compare first of all Belladonna, which is useful when the symptoms are violent; areas of redness spread out in radii from the central point of the inflammation. Phytolacca is an excellent remedy when from the beginning the breasts show a tendency to cake. Especially is Phytolacca the remedy if suppuration threatens. When the child nurses, pain goes from the nipple all over the body, streaking up and down the spine. The flow of milk is apt to be excessive.

Phellandrium aquaticum is an excellent remedy when pains course along the milk-ducts between the acts of nursing.

Croton tiglium is to be selected when there is pain from the nipple through to the back when the child nurses, as though the nipple were being pulled by a string.

Bryonia should be remembered in measles. Here it is indicated principally by the tardy appearance of the rash. There is a hard, dry cough which makes the child cry. The little one doubles up as if to resist the tearing pain which the effort of coughing causes. There may be little or no expectoration. The eyes are inflamed. In other cases the eruption suddenly disappears and cerebral symptoms appear. The child is drowsy. Its face is pale and there is twitching of the muscles of the face, eyes and mouth. Any motion causes the child to scream with pain. In other cases instead of these cerebral symptoms you have inflammatory diseases of the chest, such as bronchitis or even pneumonia.

In scarlatina, Bryonia is not often indicated, but when it is, you find some one or all of these symptoms to guide you. The rash has not that smooth character observed under Belladonna. It is interspersed with a miliary rash. It comes out imperfectly and the chest symptoms and cerebral symptoms just mentioned are present. Now while all the senses are benumbed in these cases, there are no absolute hallucinations of the senses as under Belladonna; the patients do not hear voices talking to them as under Anacardium; they do not awaken from sleep clinging to those about them, as with Stramonium or Cuprum.

When an eruption has been suppressed and the brain is affected in consequence, you may also look to Cuprum, which is the remedy when the symptoms are violent. The child starts up during sleep. There are decided perversion of the senses, and the spasms characteristic of Cuprum.

Helleborus suits when the entire sensorial life is suspended and the child lies in a profound stupor.

Zincum is to be preferred if the child is too weak to develop an eruption. The rash comes out sparingly. The surface of the body is rather cool. The child lies in a stupor, gritting its teeth; it starts up during sleep. Dilated pupils, squinting and rolling of the eyes are observed, and there is marked fidgetiness of the feet.

Ipecac, is to be thought of when the chest is affected from the recession of the rash of measles, if there is difficulty in breathing, cough, etc.

Tay'tar emetic ought to be given in preference to Bryonia when the disease is variola.

Bryonia is complementary to Alumina.

It is antidoted by Chamomilla, Nux vomica^ Pulsatilla, Rhus tox. and Senega.

It antidotes Rhus tox. , Rhus venenata and Chlorine.