Causticum hahnemanni

Sensitive to both heat and cold. Weakness, increasing uncertainty of control, stumbling, etc., finally PARALYSIS; of single parts. Atony. Anæsthesia. Stiff joints. Contracted tendons; palms (Nat-m.), hamstrings, etc. Deformities. Atrophy. Jerks of single muscles. Epilepsy, at puberty. Trembling. Burning. Soreness. Rawness; larynx, anus, etc. .................... Broken down; worn out; wants to die. Hopeless, despondent. Mental tire. Anxious forebodings (felt in head), < in twilight. Reticent. Oversympathetic. Empty behind forehead. Tight scalp. To and fro or nodding motions. Paralysis: of one eyelid (r), throat, bladder, etc. Heavy, drooping eyelids. Continuous eye pain. Diplopia, > looking to right. Objects look large. Cataract. Profuse acrid tears. Much, foul earwax. Echo in ears. Tinnitus. Eruption on lower nose. Prosopalgia, > cold water. Facial paralysis, < opening mouth. Swelling at root of tongue. Throat, < stooping. Urging to swallow, or swallows the wrong way. Greasy eructations. Cramp in rectum on stooping. Anus, prolapses on coughing; small, hard pustules. Stool glistens; difficult, > standing. Stooling easier by standing, but piles < standing. Must sit down to urinate. Insensible urethra or rectum; to solid stools (Alo.). Piles, < walking. Urine retained after labor. URINE SPURTS ON COUGHING; dribbles or passes slowly; > sitting. Menses by day, leucorrhœa by night. Dry, hard cough. Cough from tickling in throatpit (Sep.), or l. larynx; incessant; dry night and morning. Can't cough deep enough (Rum.); expectorate slips back again; < heat of bed, stooping, cold air; > sips of cold water. Greasy, ropy, difficult expectoration. Aphonia or hoarseness, in A.M.; of speakers; < stooping; > talking. Sore streak in larynx. Sore chest; vest seems tight. Purring in chest. Wandering chest pains, > pressure. Stiff neck or back on rising; pain goes forward or to thighs. Pain in spine on swallowing. Bursting in fingertips. Cramps in calves, feet or toes. Deep burns and their effects. Skin: cracks; ulcers. Warts, on brows, lids, nose, fingertips; seedy; bleeding; ulcerating. Coldness, not > warmth; causes paralysis, cough, diarrhœa, etc. Sweat about 4. A.M.; profuse, on slight exertion; < open air.

Air: DRY COLD. Raw. WINDS. Drafts. Extremes of temperature. Stooping. Suppressions. Coffee. 3-4 A.M. OR EVENING. Exertion. Change of weather.

A COLD DRINK (EVEN CHILLS). Washing. Warmth; of bed. Gentle motion.

NERVES: Motor. Sensory. MUSCLES: BLADDER. LARYNX. Limbs. Respiration. Skin. Right side; face.

Complementary: Carb-v. Grap. Lach. Stap. Related: Gel. Kali-bi. Pho. Rhus-t. Sep.

Causticum

Hahnemann s. Tinctura acris sine Kali.

Adapted to persons with dark hair and rigid fibre ; weakly, psoric, with excessively yellow, sallow complexion; subject to affections of respiratory and urinary tracts.

Children with dark hair and eyes, delicate, sensitive; skin prone to intertrigo during dentition (Lyc.), or convulsions with eruption of teeth (Stan.).

Disturbed functional activity of brain and spinal cord, from exhausting disease or severe mental shock, resulting in paralysis.

Rawness or soreness : of scalp, throat, respiratory tract, rectum, anus, urethra, vagina, uterus (as if bruised, Arn. ; as if sprained, Rhus).

Melancholy mood: sad, hopeless; from care, grief, sorrow ; with weeping, ‘hhe least thing makes the child cry.”

Intense sympathy for sufferings of others.

Ailments: from long-lasting grief and sorrow (Phos. ac.) ; from loss of sleep, night watching (Coc., Ign.) ; from sudden emotions, fear, fright, joy (Coff., Gels.) ; from anger or vexation; from suppressed eruptions.

Children slow in learning to walk (Cal. p.).

Unsteady walking and easy falling of little children.

Constipation: frequent, ineffectual desire (Nux) ; stool passes better when person is standing ; impeded by haemorrhoids ; tough and shining, like grease ; in children with nocturnal enuresis.

Urine involuntary: when coughing, sneezing, blowing the nose (Puls., Squib, Ver.),

Cough: with rawness and soreness in chest; with inability to expectorate, sputa must be swallowed (Arn., Kali c.) ; relieved by swallow of cold water; on expiration (Acon.); with pain in hips; remaining after pertussis; with expectoration chiefly at night.

Hoarseness, with rawness and aphonia < in the morning (< in the evening, Carbo v., Phos.).

At night, unable to get an easy position or lie still a moment (Eup., Rhus).

Must move constantly, but motion does not relieve.

Cannot cover too warmly, but warmth does not >.

Faint-like sinking of strength; weakness and trembling.

Cicatrices, especially burns, scalds, freshen up, become sore again; old injuries re-open; patients say “they never have been well since that burn.”

Menses: too early; too feeble; only during the day; cease on lying down.

Paralysis : of single parts ; vocal organs, tongue, eyelids, face, extremities, bladder; generally of right side; from exposure to cold wind or draft; after typhoid, typhus or diphtheria; gradually appearing.

Drooping of upper eyelids; cannot keep them open (Caul., Gels., Graph. — of both lids, Sep.).

Rheumatic affections, with contraction of the flexors and stiffness of the joints; tension and shortening of muscles (Am. m., Cimex, Guaiac., Nat.).

Warts: large, jagged, often pedunculated; bleeding easily, exuding moisture ; small, all over the body ; on eyelids, face; on the nose.

Patient improves for a time, then comes to a ‘‘standstill’' (Psor., Sulph.).

Incompatible : Phos. Must not be used before or after Phos., always disagrees; the Acids; Coffea.

Compare: Arn., must swallow mucus; Gels., Graph., Sep. in ptosis; hoarseness, Rumex and Carbo v. when < changes to evening; Sulph. in chronic aphonia.

Causticum antidotes paralysis from lead poisoning (bad effects of holding type in mouth of compositors), and abuse of Merc, or Sulph. in scabies.

It affects the right side most prominently.

Aggravation. — In clear, fine weather; coming from the air into a warm room (Bry.) ; cold air, especially draft of cold air; on becoming cold; from getting wet or bathing.

Amelioration — In damp, wet weather ; warm air.

Lecture LXXII — Causticum

Causticum is evidently a potash preparation, but its exact composition I do not know. Hahnemann was not able to define it, and chemists since his time have not been able to tell of what it is composed. Nevertheless it is a unique remedy, and is one that we cannot do without in practice. The drug is conveniently studied under the heads placed on the board.

Carbo veg.

Lachesis.

Causticum. <{ Coloc.

Rhus, Dulc.

Guaiacum.

Aconite, Colch.

Phosphorus.

Paralysis.

Spasms.

Rheumatism.

Mucous membranes.

Skin.

Organs.

It has a tendency to cause paralysis and spasmodic symptoms, rheumatism, affections of the mucous membranes, and diseases of the skin and organs generally. You will recall the fact that there is an inimical relation between Phosphorus and Causticum. These remedies do not follow each other well, although indicated in the same class of diseases. This is to be remembered particularly by those who use the higher and medium potencies.

The main power of Causticum is the first one on the list, the paralytic weakness which the drug exhibits. This paralytic tendency is a genuine potash weakness. Causticum is especially suited to patients who are timid, nervous and anxious, and full of fearful fancies, particularly in the evening at twilight, when shadows grow longer and fancy more rife. The child, for instance, is afraid to go to bed in the dark. This applies not to the unfortunate child who entertains these fears by reason of faulty education, but to the child who is afraid as the result of nervous disease. As an adult, the patient is apprehensive that something is about to happen, or he feels conscience stricken, as if he had committed some crime. When closing his eyes, he sees frightful images. This is no new symptom to you, as you will recall it as belonging to several remedies. The patient, especially if a woman, is apt to be tearful and melancholy. The face is a correct picture of the mental condition, and is expressive of this low-spirited state. The face is apt to be sallow and sickly looking. The patient is either taciturn and distrustful, or is inclined to fits of anger, with scolding. This is, as you know, by no means dissimilar to Phosphorus, and yet you must not make the mistake of giving one, when the other is indicated. Memory' fails. Any attempt at mental labor is followed by untoward symptoms, such as stitches in the temples when reading or writing, feeling of tension in the head and scalp, particularly in the forehead and about the temples. This is worse in the evening, and also on awakening from sleep. Here again it is very similar to Phosphorus, which also has that feeling of tension. The patient also has a rather odd sensation, and one that is not frequently met with, and that is a feeling as though there were an empt)^ space between the brain and the cranial bones. This is relieved by warmth. As odd as this symptom may seem to you, it is not too uncommon for you to make note of. Our materia medica is not over rich in this direction, and so we ought to utilize every such symptom that we can get.

The vertigo of Causticum is that which belongs to an excited brain and spine, such as we find in the incipiency of paralysis, and even of locomotor ataxia. There is a tendency to fall either forward or sideways. There is with this vertigo a constant feeling of anxiety and weakness of the head. It is worse on rising and on trying to fix the mind, indicating a weakened cerebral circulation. The sight is bedimmed as though the patient were looking through a fog. Now, concomitant with these brain symptoms you have the following symptoms, one or two of which ought to be present in order to make the picture complete. The skin in these cases is apt to be dry and hot, and there is almost always constipation, which constipation is quite characteristic. It is attended with a great deal of urging, probably from defective expulsive effort in the rectal muscular fibres, with redness of the face and fulness of the bloodvessels. This symptom is very common in weak persons and in children when they are nervously debilitated.

Very characteristic of the drug is paralysis of single parts or of single nerves. Thus you may have to use it in paralysis oKthe facial nerve, particularly when it is the result of exposure to dry or cold winds. It may also be called for in ptosis, when the result of the same cause. Causticum is still further called for in paralysis of the tongue, when deglutition and speech are more or less destroyed, paralysis of the lips, and in glosso-pharyngeal paralysis. In this last-named disease, you cannot expect much improvement from any remedy. The larynx and the bladder may be attacked. These are illustrations of the local palsies which come within the range of Causticum. These paralyses ma3* be caused either by deep-seated nervous disease, or, very characteristically, by exposure to cold, particularly to the intense cold of winter, when the patient is of the rheumatic diathesis.

Aconite, like Causticum , is useful in paralyses which are traceable to exposure to cold, especially to dry cold winds. Aconite suits well in the beginning, and Causticum more when the paralysis has become chronic and refuses to yield to the Aconite.

Rhus tox. and Dulcamara compare favorably with Causticum for paralysis of rheumatic origin, provoked by exposure to a damp and cold atmosphere, particularly when there have been changes from tolerably warm to cold and wet days. Dulcamara is suited to the beginning of such cases, and not when the trouble becomes chronic. Rhus tox. is suited to chronic cases.

Nux vomica and Colchicum are also to be thought of in paralysis from exposure.

Stammering has been cured by Causticum when caused by imperfect control of the tongue. In paralysis of the tongue, it may require to be followed by Stramonium, Dulcamai'a, Muriatic acid or Baryta carbonica.

You may also find Causticum indicated in paralysis which arises from apoplexy; it is not called for, for the immediate results of the stroke, not for the congestion, nor for the exudation, but for the remote symptoms, when, after absorption of the effused blood has taken place, there still remains paralysis of the opposite,side of the body.

Causticum may be applied in diseases of children. It is suited to children of a scrofulous habit in whom, though emaciated generally and particularly about the feet, the abdomen is large and tumefied. The3 T are slow in learning to talk. There is a tendency to scrofulous inflammation of the eyes, scabs form about the tarsi ; the conjunctivae become injected, and the cornea inflamed. There is a constant feeling as of sand beneath the eyelids. An eruption appears about the scalp, especially behind the ears, making this portion of the skin raw and excoriated. The discharge is slight in quantity and sticky in character. Often there is otorrhcea, purulent in its character. The child stumbles when it attempts to walk. The cause of this symptom will be found in disease of the brain or spine. These cases do not recover rapidly. There is defective nutrition in the whole nervous system. You must instruct your patients that hygienic measures must be observed in conjunction with medicinal, and that you can promise a cure if they will but be patient with you.

Other remedies which may be thought of here are, first, Sulphuric acid, which is a good remedy for this weakness or giving way of the ankles; another is Sulphur, and still another, Silicea. Still further, as illustrating the paralytic effect of Causticum, we find it causing aphonia or failure of the voice. This may or may not be catarrhal. It is associated with great weakness of the laryngeal muscles, which seem to refuse their office. This is often the case in phthisis and in laryngeal troubles, whether of a tubercular nature or not. The paralytic tendency is further illustrated in the cough. The patient is unable to expectorate. Just as under Sepia, Drosera, Kali carb., Arnica and a few other remedies, the patient succeeds in raising the sputum so far, when it slips back into the pharynx. The remedy also has this as characteristic: the patient cannot cough deep enough for relief. In addition to these paretic symptoms in catarrhs, you may also add the following: rawness and burning down the throat and trachea, feeling as if these parts were denuded, and hoarseness with aggravation in the morning. At this time, also (consistent with the action of the potash salts generally), there is accumulation of mucus in the fauces and larynx. The sputum often tastes greasy and soapy. Drinking cold water relieves the cough. Accompanying the cough, we find pain over the hips, which is very characteristic, and, too, the cough is often associated with involuntary spurting of urine. This last symptom is very characteristic of Causticum. It is also found under Natrum mur., Apis, Phosphorus, Pulsatilla and Scilla, which is excellent in spurting of urine in old people.

In the laryngeal symptoms, it is necessary to make a distinction between Causticum and Phosphorus. One point of difference is that Phosphorus often has evening aggravation of the hoarseness; Causticum has aggravation in the morning. Both have this nervous weakness. One sj'inptom I have often found indicating Phosphorus, and that is, extreme sensitiveness of the box of the larynx. The patient dreads to cough, because it aggravates the laryngeal soreness. He dreads to talk for the same reason. Relief from cold drinks is found only under Causticum.

More similar to Causticum yet, is Carbo veg. Here you can make no serious mistake, because both drugs follow each other well. If you do make the mistake of giving one of these when the other is indicated, you will not injure your patient any more than from the delay caused by your imperfect selection. Both remedies have this rawness and soreness down the throat ; both have hoarseness, Carbo veg. having aggravation in the evening and Causticum in the morning. The former is indicated after exposure to damp evening air; the latter, after dry, cold, severe winter weather.

Eupatorium perfoliatum is very similar to Causticum in that it causes hoarseness worse in the morning. Both remedies are indicated in influenza with aching all over the body, but Eupatorium has more soreness than burning and rawness in the chest.

In the hoarseness of singers or those who exert their voices a great deal, Causticum resembles Rhus tox., Graphites, Arum tri. and Selenium. In some cases, when Causticum fails in chronic hoarseness worse in the morning or evening, Sulphur is an all-sufficient remedy. Still another kind of cough for which you may give Causticum is one which improves up to a certain point and then remains stationar)', getting neither better nor worse.

Causticum is a good remedy for buzzing and roaring in the ears, or tinnitus aurium, when sounds reecho unpleasantly in the ears. A voice which is of an ordinary tone, sounds loud and reechoes in the ear with unpleasant confusion. When Causticum is the remedy, these symptoms may be concomitant with catarrh of the throat involving the Eustachian tube. They may also be symptoms of Meniere's disease, of which affection I once cured a case with Causticum.

There are two drugs which you may compare here, namely. Salicylic acid and Salicylate of Soda, which have caused and cured Meniere's disease.

You may also compare Carbon bisulphide and the well-known Cinchona.

When sounds reecho in the ear, think also of Calcarea ostr. and Phosphorus.

We find Causticum indicated in involuntary urination or enuresis, particularly in children. It is especially called for when the accident occurs, during the first sleep. The trouble is aggravated in the winter and ceases or becomes more moderate in summer. The urine is especially liable to escape involuntarily during the day in winter, as the result of any excitement.

Compare in enuresis, Plantago major and Kreosote (involuntary discharge of profuse, pale urine); Calcarea ostr. (fat children); Sepia, (little girls, worse in first sleep); Belladonna (nervous children); Ferrumphos. (during the day).

For nursing women we may use Causticujn when over-exertion or loss of sleep threatens their supply of milk. This makes them very low-spirited, and they are apt to have this sallow, sickly complexion which is characteristic of Causticum.

Causticum may be used in spasmodic diseases, even in convulsions. Thus it may be used in epilepsy, particularly in la petit mat. When walking in the open air, the patient falls, but soon recovers. During the unconscious stage, the patient passes urine. Causticum may even be used when the attacks are of a convulsive nature, especially when they recur at the new moon. Now you are not to consider that the moon has anything to do with these epileptic attacks. It is only the laws which govern the relation of the planets, which regulate the tides and have to do with the periodicity of nature generally that also apply to the moon and to the disturbances within the human body; so it is that some symptoms are worse at new moon, others at full moon; some at the rise and others at the fall of the tide. It does not, therefore, follow, because the patient is worse every time at new moon, that the moon causes the aggravation. Causticum is, moreover, indicated in epilepsy when it is connected with menstrual irregularities, and also when it occurs at the age of puberty. In these symptoms Causticum is closely allied to Calcarea ostrearum.

Causticum is indicated in chorea when the right side of the body is affected more than the left. The muscles of the face, tongue, arm and leg are all involved in the disorderly movements. When the patient attempts to speak, words seems to be jerked out of the mouth. The patient is anxious and restless in bed at night. He must sit up and change his position. He involuntarily throws the head about, and finally he falls asleep exhausted. During sleep the legs and arms are constantly " on the go."

Lastly, we may be called upon to use Causticum in rheumatism, especially when the joints are stiff and the tendons shortened, drawing the limbs out of shape. It is frequently indicated in what has been termed rheumatoid arthritis. Rheumatic pains attack particularly the articulation of the jaw. They are worse from cold and are relieved by warmth.

Causticum is also useful in rheumatism of the right deltoid, here being comparable with Phosphoric acid, Sanguinaria and Ferritin. Now, you will have to distinguish Causticum here from several other remedies. Rhus tox. also has rheumatism from exposure to cold. Some of the distinctions between it and Causticum I have already given you. There is yet another good one. Rhus tox. has restlessness and relief from motion all the time. In Causticum the restlessness only occurs at night. Further Rhus is worse in damp weather, Causticum in dry weather.

Guaiacum is to be preferred to Causticum, and follows that remedy well when, in either gout or rheumatism, there are contractions of the tendons, drawing the limbs out of shape, aggravated by any attempt at motion, particularly if there are well-developed gouty nodosities in the joints.

Colocynth is to be remembered for articular rheumatism when the joints remain stiff and unwieldy. The pains in the affected parts are of a boring character.

Causticum also acts on the skin, one of its most characteristic symptoms being warts. It is useful in the cure of these hypertrophies of the papillae when they occur on the hands or face. I remember once giving Causticum to a child who had two warts on the under eyelid. At the end of the third week after taking the remedy, there was a string of warts over the inner canthus of the other eye. I believed that these resulted from the Causticum. Of course, I stopped the medicine. At the end of several weeks more, all the warts had disappeared, and the child has had none since. This shows you that Causticum really produces and cures warts.

Causticum may be called for in colic after the failure of Colocynth. The pains are of a griping, cutting character, and are relieved by bending double. Particularly do you find pains of this character suggesting the drug in menstrual colic. Previous to the menses, these colicky pains appear, and are associated with tearing pains in the back and limbs. The menses cease almost entirely at night, or continue for days after the normal time. All the sufferings cease entirely at night.

Child does not want to go to bed alone. Least thing makes it cry. Sad, hopeless. Intensely sympathetic. Ailments from long-lasting grief, sudden

emotions. Thinking of complaints, aggravates, especially hæmorrhoids.

Hahnemann's Tinctura acris sine Kali Manifests its action mainly in chronic rheumatic, arthritic and paralytic affections, indicated by the tearing, drawing pains in the muscular and fibrous tissues, with deformities about the joints; progressive loss of muscular strength, tendinous contractures. Broken down seniles. In catarrhal affections of the air passages, and seems to choose preferably dark-complexioned and rigid-fibered persons. Restlessness at night, with tearing pains in joints and bones, and faint- like sinking of strength. This weakness progresses until we have gradually appearing paralysis. Local paralysis, vocal cords, muscles of deglutition, of tongue, eyelids, face, bladder and extremities. Children are slow to walk. The skin of a Causticum person is of a dirty white sallow, with warts, especially on the face. Emaciation due to disease, worry, etc, and of long standing. Burning, rawness, and soreness are characteristic.

Worse, dry, cold winds, in clear fine weather, cold air; from motion of carriage. Better, in damp, wet weather; warmth. Heat of bed.

Sensation of empty space between forehead and brain. Pain in right frontal eminence.

Paralysis of right side. Warts. Pain in facial bones. Dental fistula. Pain in jaws, with difficulty in opening mouth.

Cataract with motor disturbances. Inflammation of eyelids; ulceration. Sparks and dark spots before eyes Ptosis (Gels). Vision impaired, as if film were before eyes. Paralysis of ocular muscles after exposure to cold.

Ringing, roaring, pulsating, with deafness; words and steps re-echo; chronic middle-ear catarrh; accumulation of ear-wax.

Coryza, with hoarseness. Scaly nose. Nostrils ulcerated. Pimples and warts.

Bites inside of cheek from chewing. Paralysis of tongue, with indistinct speech. Rheumatism of articulation of lower jaw. Gums bleed easily.

Greasy taste. Aversion to sweets. Feels as if lime were burned in stomach. Worse after eating fresh meat; smoked meat agrees. Sensation of ball rising in throat. Acid dyspepsia.

Soft and small, size of goose-quill (Phos). Hard, tough, covered with mucus; shines like grease; small-shaped; expelled with much straining, or only on standing up. Pruritus. Partial paralysis of rectum. Rectum sore and burns. Fistula and large piles.

Involuntary when coughing, sneezing (Puls). Expelled very slowly, and sometimes retained. Involuntary during first sleep at night; also from slightest excitement. Retention after surgical operations. Loss of sensibility on passing urine.

Uterine inertia during labor. Menses cease at night; flow only during day (Cycl; Puls). Leucorrhœa at night, with great weakness (Nat mur). Menses delay, late (Con. Graph; Puls).

Hoarseness with pain in chest; aphonia. Larynx sore. Cough, with raw soreness of chest. Expectoration scanty; must be swallowed. Cough with pain in hip, especially left worse in evening; better, drinking cold water; worse, warmth of bed. Sore streak down trachea. Mucus under sternum, which he cannot quite reach. Pain in chest, with palpitation. Cannot lie down at night. Voice re-echoes. Own voice roars in ears and distresses. Difficulty of voice of singers and public speakers (Royal).

Stiffness between shoulders. Dull pain in nape of neck.

Left-sided sciatica, with numbness. Paralysis of single parts. Dull, tearing pain in hands and arms. Heaviness and weakness. Tearing joints. Unsteadiness of muscles of forearm and hand. Numbness; loss of sensation in hands. Contracted tendons. Weak ankles. Cannot walk without suffering.

Rheumatic tearing in limbs; better by warmth, especially heat of bed. Burning in joints. Slow in learning to walk. Unsteady walking and easily falling. Restless legs at night. Cracking and tension in knees; stiffness in hollow of knee. Itching on dorsum of feet.

Soreness in folds of skin, back of ears, between thighs. Warts large, jagged, bleeding easily, on tips of fingers and nose. Old burns that do not get well, and ill effects from burns. Pains of burns. Cicatrices freshen up; old injuries reopen. Skin prone to intertrigo during dentition.

Very drowsy; can hardly keep awake. Nocturnal sleeplessness, with dry heat, inquietude.

According to the careful investigations of Dr. Wagner of Basel, Causticum corresponds to Ammon causticum 4x. Causticum does not agree with Phosphorus; the remedies should not be used after each other. Diphtherotoxin follows, causticum in chronic bronchitis. Antidote: Paralysis from lead-poisoning. Complementary: Carbo; Petrosel. Compare: Rhus; Arsenic; Amm phos (facial paralysis).

Third to thirtieth attenuation. In chronic ailments and especially in paralytic states, the higher potencies once or twice a week.

Causticum

Causticum is a very searching medicine, suitable in old, broken down constitutions, suffering from chronic diseases.

Only occasionally is it indicated in acute diseases. Its complaints are such as are progressive, slow, and accompanying a declining state of the economy.

Muscular power: Gradual decrease of muscular power, a paralysis. Paralysis of the oesophagus, paralysis of the throat, such as occurs after diphtheria; paralysis of the upper eyelids; paralysis of the bladder; paralysis of the limbs, of the lower limbs; great lassitude, muscular relaxation, indescribable fatigue and heaviness of the body. And there is a tremulousness, a quivering, jerking, twitching of the muscles, twitching in sleep.

Tendons: The next most striking feature is found in the tendons, which become shortened, resulting in a temporary or permanent contracture, and the limb is drawn up. Tendons of the forearms contract, and there is gradually increasing flexion. Sometimes a whole muscle will harden and shorten, so that it can be felt by the hand as a hard ridge. Contractures of muscles and tendons.

Joints: Closely related to this is a rheumatic state of the tendons and ligaments about the joints, sometimes with swelling, but always with pain and ending in a shrivelling of the joint, a tightening up of the joint so that it becomes ankylosed.

Great stiffness of the joints, and while this is going on the patient is growing weaker, is running into a state of melancholy, of hopelessness, anxiety and fear.

Constantly present in his mind is the hopelessness and a feeling that something is hanging over him, that something is going to happen. These are general features of Causticum. They all go to make up one picture, they are inseparable.

Hysteria: Another kind of progressive trouble in Causticum is hysteria. Gradually increasing hysteria. Hysterical cramping. The woman loses all control of herself and says foolish things. Her nervous system becomes extremely sensitive to noise, touch, excitement or anything unusual. Starting from the slightest noise; starting in sleep; twitching and jerking; the child is easily startled, or acts as if startled without cause.

Rheumatic diathesis: The paralytic weakness is associated with the rheumatic diathesis. The rheumatic states are peculiar. The patient himself can endure neither heat nor cold. They both aggravate his rheumatic conditions, his nervous conditions and himself in general. His pains are ameliorated by heat, but they are aggravated in dry weather.

Great deformity of the joints; they are enlarged, soft and infiltrated, always worse in dry weather; more pains and aches during dry weather. Rheumatism that affects both the muscles and the joints. This patient is also aggravated by exposure to cold, dry winds. Many an individual who has gone from the low lands of the East up into Colorado will come down with rheumatism from the cold, dry winds.

Let such a patient as I have described take a ride in the cold lake wind and he will have paralysis of the side of the face exposed to the wind. A long drive with the east wind coming against the face. The next day that side of the face will be paralyzed. Such a paralysis will almost always recover under Causticum.

Reading, tearing, paralytic pains; pains that, benumb; pains that fairly take the life out of him, they are so severe. And they are likely to remain in one place for a long time. Causticum has often greatly mitigated the lightning-like pains of locomotor ataxia.

Now, with all these sufferings the patient is slowly growing weaker, till at length he can no longer walk, he can no longer sit up, he is so tired and weak that he must lie down. He is tired in body and mind. It is a paralytic fatigue. Convulsive symptoms. Cramps, now here, now there. If frightened he is almost sure to have some form of convulsive condition, The woman with tendency to hysteria will have hysterics from fright; nervous girls that are more inclined to chorea, will start with jerking of muscles and will keep it up day and night. Chorea even at night. Localized chorea, jerking of single parts, chorea of the tongue or of one side of the face. Epilepsy in young persons at the age of puberty, from fright, from, being chilled or exposed to some great change in the weather. Epilepsy, chorea, paralysis, hysteria worse during menses. We see that Causticum is a deep medicine. Worse from exposure to cold, dry wind. It also has rheumatic complaints aggravated in the warm, damp days, in wet weather, but this is not so striking.

Any one of the complaints that I have mentioned may be brought on by bathing in cold water. A long, dry, cold spell will aggravate the rheumatic troubles, getting wet or becoming chilled by bathing will start them.

Insanity: Causticum has cured insanity; not acute mania with violent delirium, but mental aberration of the passive kind, where the brain has become tired. The constitution has been broken down with long suffering and much trouble, and finally the mind is in confusion. At first the patient recognizes his inability to do anything and then comes this foreboding that something is going to happen. He is unable to think, and consequently unable to carry on his business. He is going into imbecility. Full of timorous fancies.

"Timorous anxiety," overwhelmed with fearful fancies.

At every turn there is fear that something is going to happen. Fear of death, fear that something will happen to his family. Always anticipating some dreadful event. That is a striking feature of the Causticum mental state. It is found in old, broken down mental cases, after prolonged anxiety; after a prolonged struggle of some sort.

Anxiety before falling asleep. In addition to this, the Causticum patient lacks balance. Everything excites him. The more he thinks about his complaints, the worse they become. Mental and other ailments from long-lasting grief and sorrow. The injurious effects of fear and prolonged vexation. Tired from vexations of business.

Eruptions: The suppression of eruptions is apt to bring out mental symptoms. Mental exhaustion, hopelessness, despair, appearing after the suppression of an eruption with zinc ointment. He was fairly well while he had the eruption, but when it disappeared his mind gave out. Eruptions on the side of the head and face, and extending over the whole head. Thick, crusty eruptions covering the whole occiput. When these eruptions are suppressed in children, chorea is apt to follow. In the adult there will be trembling, paralytic weakness and the mental state, sometimes pains in the nerves.

Headaches: The driving in of a facial eruption will frequently result in facial paralysis. The healing of an old ulcer with stimulating lotions and ointments will have a similar result. Then he also suffers from violent headaches, congestive, pulsating headaches; violent, stitches in the head, worse in the evening.

But the headaches are, as a rule, nondescript; only occasion do we find a Causticum headache standing out by itself. It will usually be associated with rheumatic and gouty conditions which also affect the scalp. The scalp contracts and tightens up in places like the contractures in other parts. Rheumatic headaches; sometimes the pain is so severe as to cause nausea, and vomiting. Blinding headaches followed by paralysis.

Torticollis. The head is sometimes drawn to one side by the shortening of the muscles of the neck. Causticum is a curative remedy in this shortening of the tendons and muscles.

Eyes: Causticum is rich in eye symptoms. Very often the patient says that the eyelids feel so heavy that he can hardly hold them up. This gradually increases until it becomes an actual paralysis. Sometimes there is the appearance of a veil before the eyes; foggy vision. Flickering before the eyes. Air seems full of little black insects. Then, again, large black or green spots are seen. After looking at the light a green spot appears and remains in the field of vision for a long time. Diplopia.

And the vision gradually grows weaker until it is lost. Paralysis of the optic nerve. Lachrymation, tears acrid, burning; ulceration, copious discharges from the eyes, agglutination of the lids, paralysis of the eye muscles.

Causticum cures scrofulous ophthalmia with ulceration of the cornea; chronic, purulent ophthalmia of psoric origin. The cornea is covered with little veins.

Warts: Another very strong feature of this medicine is its tendency to grow warts. Warts on the face, on the tip of the nose, on the ends of the fingers, on the hands.

Hard, dry, horny warts come out on various parts of the body.

It is natural feature of this remedy to produce copious, thick, tough, gluey discharges from mucous membranes.

Ear and nose: The catarrhal troubles creep up the Eustachian tube, from the nose and throat into the car, resulting in roarings, cracking noises and reverberations in the ear. There is great accumulation of car wax; deafness of catarrhal origin and deafness from paralysis of the auditory nerve. Severe, dragging pains in the ear.

The nasal catarrh is very troublesome. Old, atrophic catarrh with accumulation of crusts throughout the whole nasal cavity; post-nasal catarrh with ulcerations, granulations and copious, thick, yellow or yellowish-green discharge; nose-bled; frequent attacks of acrid, watery coryza. Much itching of the nose. A wart grows upon the tip of the nose.

Face and mouth: The pains in the face are violent. Neuralgic pains from exposure to cold. These pains often accompany the facial paralysis. Tearing pains in the face, stitching pains, pains of a rheumatic character.

Ulcerations about the mouth and nose. Fissures about the lips, the wings of the nose and the corners of the eyes. Fissures seem to form upon the least provocation. Fissures of the anus, of the skin about the joints. Old cases of salt rheum with fissures in the bends of the joints. Fistulous openings with indurated walls.

The gums become scorbutic and settle away from the teeth; bleeding and ulceration of the gums. Violent, tearing pains in the roots of the teeth from riding in the wind. Old rheumatic subjects suffer all through every dry spell with toothache.

Stitching, tearing, pulsating pains in the teeth; even in the sound teeth on drawing in cold air. Frequently recurring abscesses of the gums. Putrid sour or bitter taste in the mouth. When the paralytic condition affects the tongue then we have stammering. There is also the condition of complete paralysis of both the pharynx and oesophagus. Hence Causticum is useful in the results of diphtheria when it has been maltreated or when the remedy has not been sufficient to cure the disease.

The food goes down the wrong way or enters the larynx or the post-nares. Paralysis of the organs of speech, paralysis of the tongue, awkward at talking, awkward at chewing; bites the tongue and cheeks while chewing. Post-diphtheritic paralysis is a serious condition and only a few remedies can cure- it.

Causticum is one of them. Lachesis and Cocculus are also important. Dryness of the mouth and throat; rawness of the throat; must swallow constantly on account of a sensation of fullness in the throat, a nervous feeling in the throat. This is often a forerunner of paralysis. The Staphysagria patient when excited will keep up a constant swallowing and this goes on until it becomes a source of great annoyance.

Burning in the throat; jerking in the throat; constantly scraping thick, tough mucus from the larynx. Study the sounds that patients make in order to ascertain where the mucus comes from. The presence of hoarseness shows that the trouble is in the larynx.

Desires and aversions, stomach: The Causticum patient sits down to the table hungry, but on seeing the food his appetite vanishes. The thought, sight or smell of food takes away the appetite. This is a common symptom in the pregnant woman.

Although hungry, on sitting down at the table, she cannot eat. Kali carbonicum has an empty, all-gone feeling in the stomach, with aversion to food. China has canine hunger, but loathes the sight of food.

Thirst after eating; thirst for cool drinks with aversion to water desire for beer, smoked meats, pungent things, aversion to sweet things and delicacies. Most remedies that have loss of appetite have desire for, sweet things, pastry, etc. The symptoms of thirst with aversion to drinking is very much like Lachesis.

The two run very closely together in the paralytic condition of the throat. There is a queer sensation in the stomach as if lime were slaking there. Trembling in the stomach; burning. Bread causes a sensation of heaviness and pressure, coffee seems to aggravate all the symptoms of the stomach, but a swallow of cold water relieves.

Many symptoms in this remedy are made better by a swallow of water. The violent spasmodic cough may be stopped at once by a drink of cold water. Cold water seems to tone up the paralytic condition. Warm water applied to the hands brings on pains in these old sensitive spinal conditions. Cold washing is their only relief. Causticum has belching, nausea, vomiting, distension and violent pains in the stomach. Pinching colic.

Rectum: In the rectum there is the same tendency to paralytic weakness that is found in other parts of the body. It is inactive and fills up with hard faeces, which pass involuntarily and unnoticed. Aloe has involuntary dropping of little, hard balls, especially in children. Even when old enough to understand about such things, they will pass little balls unnoticed.

On account of the paralytic condition the stool passes with less straining while the patient is standing. Retention of urine except when standing; unable to pass it in any other position is Sarsaparilla. Constipation, frequent, unsuccessful urging to stool. The stool is tough and shining, and is passed with great difficulty and exertion.

Fissures in the anus; itching and stitching in the rectum, excessive itching day and night; hemorrhoids, pulsating in the perineum I fissures and hemorrhoids pulsate and burn like fire. The hemorrhoids become infiltrated and hardened.

Bladder: This remedy has two kinds of paralysis of the bladder, one affecting the muscles of expulsion and the urine is retained, and the other center ing upon the sphincter vesicae, and then the urine is passed involuntarily.

"He urinates so easily that he is not sensible of the stream and scarcely believes, in the dark, that he is urinating, until he makes sure by sense of touch."

Causticum is unconscious of the stream as it passes.

It is a very useful remedy in children that wet the bed. Especially is it a wonderful remedy in the woman. The urine escapes involuntarily when coughing. Retention of urine in the woman. Retention after labor.

Paralysis of the bladder. A woman who is too greatly embarrassed to pass through a crowd of observing men to the closet at the end of a railroad car, at the end of the journey finds that she is unable to pass the urine.

Retention of urine from straining the muscles of the bladder. If the patient is chilled at the time the remedy may be Rhus.

Rhus and Causticum are the two great remedies for paralytic weakness of muscles from being overstrained, or from being overstrained and chilled. Great weakness at the time of the menses.

Menstruation: Anxious dreams before menstruation; melancholy; cramp-like spasms; pains in the back. The woman suffers from many annoyances during menstruation just about the time for the flow to start violent cramp-like pains come on. In a woman who is nursing a child the milk almost disappears in consequence of fatigue, night watching and anxiety. The nipples get sore and crack, another instance of the tendency to form fissures.

Voice: The Causticum patient has trouble with the voice. You remember, when we were going over the symptoms of Carbo vegetabilis, I told you that the hoarseness was worse in the evening. Now observe that the hoarseness of Causticum is worse in the morning.

He gets up in the morning with a hoarse voice; if it is an ordinary case, after moving about and expectorating a little mucus, it is better. Sudden loss of voice from paralysis of the vocal cord. It sometimes begins with the morning aggravation, gradually increasing until it lasts all day and all night.

Cough: The Causticum cough is a hard cough and racks the whole body. The chest seems full of mucus and he feels if only he could cough a little deeper he could get it up, and he struggles and coughs until exhausted or until he finds out that a drink of cold water will relieve. But it must be ice cold.

The cough is hollow, it sounds as if he were coughing into a barrel. It is relieved by expectoration if it can only get deep enough to reach the mucus. Sometimes such a cough precedes quick consumption. It is a deep-acting medicine; it cures phthisis, especially mucous phthisis or quick consumption.

"Cough with a sensation as if the patient could not cough deep enough to start the mucus; produced by tickling, accompanied by rawness. Cough wakens her from sleep in the evening and morning.

Cough relieved by a swallow of cold water. Cough worse by bending forward. Continual, annoy ing cough; with each cough escape of urine."

Influenza with tired aching of the limbs as if they had been beaten.

"Whooping cough in the catarrhal stage." Great soreness and tightness of the chest, oppression of the chest it feels as if a load were upon it. It seems to be filling up with mucus, and the patient coughs until he raises a mouthful and then he feels a little better for a time. Pale as death, covered with sweat.

Back: There are many symptoms in the back. Pain and stiffness; stiffness on rising from a seat. Stiffness in the limbs, through the hips and in the back, so that he rises up from sitting or the recumbent posture with great difficulty. In most cases the pains and aches are ameliorated by the warmth of the bed and by applied heat. Only the pains in the fingers are sometimes brought on by heat.