Gelsemium sempervirens

Heavy single parts, heart, liver, etc. Lies quietly, half reclining. Nerve exhaustion. Dull, drowsy and dizzy. TREMOR; or twitches of single muscles, face, chin, tongue, etc.; wants to be held. Chorea, of pregnancy. Paretic effects; eyes, throat, anus, bladder, etc. Inco-ordination. Fulness. Passive congestion. Symptoms accompanied by vertigo, eye or visual effects, drowsiness or polyuria. .................... CONFUSED, dazed, apathetic, torpid, dull, drowsy and dizzy, or indifferent; answers slowly. DREAD of falling; of ordeals, death, pains, etc. VERTIGO; drunken; in occiput. Headache; dull, HEAVY, band-like, occipital, to over eyes; < tight hat; swelled feeling; basilar. Meningitis. Apoplexy. Suffused, sore, aching eyes. HEAVY, DROOPING EYELIDS. VISION; double; swimming; blind spells; affected, then migraine. Face full, dusky-red; heavy, expressionless; besotted. Ciliary neuralgia; pains into ears on swallowing. Pains to occiput. Nose stuffed. Sneezing; thin, acrid coryza. Sensation as of hot water flowing from the nostrils. Heavy tongue; thick speech. THIRSTLESS. Griping in gall- bladder. Copious, yellow stools. Painless, nervous diarrhœa. Rectal pains after labor. Clear, watery urine, > headache. Alternate pelvic and head symptoms. Atonic seminal losses. Heavy, sore uterus; it feels grasped. Dysmenorrhœa. Labor pains go up, backward or down thighs. Rigid os. Deep yellow leucorrhœa. Hoarse, during menses. Tiresome breathing. Chest; as of a lump behind sternum; congestion. Heart sore; threatens to stop, must move. Spine, dull pains up and down, > walking; with occipital pain. Pains under scapulæ. Hard ache in r. humerus. Wants hands in cool water. Heavy lower limbs. Weak knees, < descending. Tottering gait; can't direct his legs. Moist, yellow skin. DROWSINESS; starts on dropping to sleep. Heavy, stupid sleep. Full, round, soft pulse. Blood rushes from occiput to forehead. Visual disturbances, then chill. Chilly and achy; with languor (Sil.); mingled or alternating with heat; up and down back. Cold hands and feet. Heat with sopor. ABSENCE OF THIRST, or trembling. Cold sweat on genitals. Fevers; bilious-remittent; malarial; cerebro-spinal. Measles. Ebullitions and heats. Sluggish fever. Shuddering chill.

EMOTIONS; DREAD. Surprise. Shock. Ordeals. Motion. Weather: SPRING. Foggy. HUMID. Muggy. Heat of summer. Periodically. Dentition. Tobacco. Gas.

Profuse urination. Sweating. Shaking. Alcoholic drinks. Mental effort. ACHING, TIRED, HEAVY, WEAK AND SORE; < limbs. Grippe. Overpowering aching.

CIRCULATION. BRAIN CORD: OCCIPUT. Base. Neck. MOTOR NERVES: MUSCLES. Knees. EYES (LIDS. VISION.) MUCOUS MEMBRANES: Nose. Gall-ducts. Right side.

Complementary: Arg-n. Sep. Related: Con. Ign. Mur-ac. Nat-m. Sep. Ver-v.

Gelsemium sempervirens

Yellow Jasmine. Loganiaceae.

For children, young people, especially women of a nervous, hysterical temperament (Croc., Ign.).

Complete relaxation and prostration of whole muscular system, with entire motor paralysis.

Excitable, irritable, sensitive; for the nervous affections of onanists of both sexes (Kali p.).

Bad effects from fright, fear, exciting news and sudden emotions (Ign. — from pleasant surprise, Coff. ) .

Fear of death (Ars.) ; utter lack of courage.

The anticipation of any unusual ordeal, preparing for church, theatre, or to meet an engagement, brings on diarrhoea; stage fright, nervous dread of appearing in public (Arg. n.).

General depression from heat of sun or summer.

Weakness and trembling; of tongue, hands, legs; of the entire body.

Desire to be quiet, to be let alone; does not wish to speak or have any one near her, even if the person be silent (Ign.).

Vertigo, spreading from the occiput (Sil.) ; with diplopia, dim vision, loss of sight; seems intoxicated when trying to move

Children ; fear of falling, grasp the crib or seize the nurse (Bor., Sanic.).

Headache; preceded by blindness (Kali bi. ), > by profuse urination.

Lack of muscular co-ordination ; confused ; muscles refuse to obey the will.

Headache : beginning in the cervical spine; pains extend over the head, causing a bursting sensation in forehead and eyeballs (Sang., Sil., begins in same way, but semi-lateral) ; < by mental exertion; from smoking ; heat of sun ; lying with head low.

Sensation of band around the head above eyes (Garb, ac., SulpE) ; scalp sore to touch.

Fears that unless on the move heart will cease beating (fears it would cease beating if she moved, Dig.).

Slow pulse of old age.

Great heaviness of the eyelids ; cannot keep them open (Caust., Graph., Sep.).

Chill without thirst, especially along the spine, running up and down the back in rapid, wave-like succession from sacrum to occiput.

fever; Ipecac, in dumb ague, after suppression by quinine.

Aggravation. — Damp weather; before a thunderstorm; mental emotion or excitement; had news; tobacco smoking; when thinking of his ailments; when spoken to of his loss.

Lecture XV — Gelsemium sempervirens

Gelsemium sempervirEns is a yellow-flowering plant indigenous to the South. It is an evergreen, and puts forth its fragrant flowers among the earliest in the spring. It is highly poisonous; especially active in this respect is the bark of the roots. During our late civil war this plant was largely used in the South as a substitute for Opium as a narcotic.

It is a member of the Loganiaceae, all of which are more or less poisonous. From this order we obtain also Nux vomica, Ignatia and Spigelia.

Its alkaloid, Gelsemi?ie, is a mydriatic like Atropine and Duboisine. Applied locally or used internally in large doses, it dilates the pupil. Given internally in small doses, however, it contracts the pupil. To acquire a thorough knowledge of Gelsemium will not tax you much. Its sphere of action is well defined. In poisoning cases we find that the prominent and universal symptom is paralysis of the motor nerves. Keep this fact before you and the symptoms of this remedy will be readily understood, especially if you apply the paretic action to both voluntary and involuntary muscles. The mind is at first clear; or there may be a slightly stupefied condition as in the case of alcoholic intoxication, a sluggishness in thought and in emotion. Later in the toxic effects of the drug you will note that the sphincters become relaxed; the anus remains open, permitting the escape of faeces. Urine escapes freely and involuntarily. Still later, respiration becomes labored, as though the muscles had not the power to lift the chest. Finally, the heart-muscle gives out, and the patient dies. Looking, then, at these symptoms as presenting in a nutshell the action of this drug, we find that it is a depressant. It acts upon the cerebro-spinal system, particularly upon the anterior columns of the cord. We also see that, by producing this sluggishness of thought, this stupid state of the mind, it must have an action on the vascular system. It is through the vaso-motor nerves that it produces passive congestion, and this congestion may be either venous or arterial. Passive congestion is generally of venous origin; but under Gelse??iium the passive hyperemia refers to both arteries and veins. In addition to this nervous action of the drug, it has something of an affinity for the mucous surfaces, giving rise to catarrhal inflammations. It is not difficult with this outline of the drug to fill in the characteristics. We find that, in obedience to its paralytic action, it causes diplopia. This double vision, when Gelsemium is the remedy, comes from paresis of the muscles of the eye.

Ptosis, or paralysis of the upper lid, calls for Gelsemium when it is associated with thick speech and suffused redness of the face. The eyeballs feel sore, the soreness being worse on moving the eyes. In this last symptom it is similar to Bryonia.

In ptosis we may compare Gelsemium with Causticum, Rhus toxicodendron, Sepia, Kalmia, and Alumina. Rhus tox. is useful in ptosis, or, in fact, in paralysis of any of the ocular muscles, when the disease occurs in rheumatic patients as a result of getting wet. Sepia is indicated in ptosis when it is associated with menstrual irregularities.

Kalmia is also useful in ptosis of rheumatic origin, when attended with a sensation of stiffness in the lids.

Causticum, in the ptosis of rheumatic subjects.

Alumina is indicated in ptosis associated with rectal inertia and consequent constipation.

Returning now to Gelsemium, we find that there is difficulty in swallowing, dysphagia, as it is called. This symptom is due to defect in the muscles of deglutition.

Gelsemium also acts upon the larynx, causing aphonia, or want of voice; the patient may be able to whisper, but he can scarcely utter any sounds on account of the paretic state of the laryngeal muscles. This symptom is frequently observed in hysterical women especially after emotions of a depressing character. Paralysis after emotion is noted under other drugs; for example, under Natrum mur., which has, " the arm almost loses its power after a fit of anger;" Stannum, paralysis mostly left-sided with perspiration of the affected part; Staphisagria, paralysis of one side from anger.

The heart is affected by Gelsemium; on going to sleep the patient is suddenly aroused by a feeling that the heart will stop beating. He feels that the heart would cease to beat if he did not move about. Here the heart-muscle is in a weakened state, and there is a sort of instinct on the part of the person to move about to stimulate it to act. Digitalis has a symptom which is just the reverse of this, namely, the patient fears that the heart will cease beating if he makes any motion.

Grindelia robusta has great weakness of the heart and lungs. When the patient drops off to sleep he wakes up suddenly with a sensation as if respiration had ceased.

In post-diphtheritic paralysis, Gelsemium is our most valuable remedy. In one very severe case of this disease under my care, Gelsemium effected a perfect cure. The child did not have sufficient strength to hold herself up. The spine in the upper cervical region was bent backward. One side of the body was paralyzed. In attempting to walk, the child would shuffle along as though she had no control over the muscles. If she attempted to turn around, she would fall. The speech was thick and heavy, as though the tongue were too large for the mouth. There was marked strabismus. But sensation was nearly perfect. I ordered the patient to be stripped twice a day, laid on the bed, and thoroughly rubbed. I gave her Gelsemium internally, and under the use of this remedy she made a perfect recovery. I doubt whether Gelsemium will cure paralysis of organic origin, where there are tissue alterations in the brain, the spinal cord, or the peripheral nerves themselves.

Gelsemium is useful in some cases of headache. I said a few moments ago that it causes a passive congestion, and by that I mean, not a violent, sudden afflux of blood to a part, but a dilated condition of the bloodvessels, such as may be found under Ferrum phos. The headache begins in the nape of the neck, passes up over the head, and settles down over the eyes. It is usually worse in the morning, and is accompanied by stiff neck, or it begins at 2 or 3 a. m. and reaches its acme in the afternoon. The patient cannot think effectively or fix his attention. He becomes listless and stupid; he has dizziness with blurred sight and heaviness of the head. These symptoms are alleviated by the discharge of watery-looking urine.

Oleum animale has cured megrim with polyuria, the urine being perfectly clear. Compare also Ignatia, Sa?iguinaria } Kalmia, Melilotus, Aconite and Silicea.

The face is a suffused red color. The eyes grow heavy and bloodshot. There is great difficulty in lifting the upper lids; often, too, the speech is thick, as though the tongue were unwieldy. Altogether, the face has the appearance of one under the influence of liquor. Thought is slow, so that the patient answers questions either slowly or imperfectly. This condition is accompanied by a pulse which is full and round, and seems to flow under the fingers like a current of water. It resembles the Aconite pulse, but lacks the tone of the latter. It is not hard and unyielding like the pulse of Aco?tite. Not infrequently the headache is preceded by blindness, as under Psorinum.

Here, then, you have symptoms which suggest Gelsemium in a variety of diseases. How useful it ought to be in the congestive stage of spotted fever! In addition to the symptoms already mentioned, there is another which is characteristic of spotted fever, namely, depression; the system seems to be laboring under the effect of some poison which it cannot overcome. So you have every indication here for the use of Gelsemium in that dreaded disease. But when the case advances to active inflammation, or when there is effusion, Gelsemium gives place to other remedies.

In addition to the headache above described, there is another form which is associated with a feeling as though there were a band around the head, or across the forehead.

Let us now consider the fever of Gelse?nium. It causes a fever which is remitting or intermitting in its type. You will find it a valuable remedy in the remitting types of fever in children. During the febrile exacerbation they are very nervous and restless, tossing about continually. (You must not give Aconite in these cases, unless the mental symptoms of that remedy are present.) The face has the suffused redness I mentioned above, and there is drowsiness. When aroused from this drowsy state the child is peevish, irritable, nervous, even somewhat excitable, but there is never the violent tossing about of Aconite. In extreme cases the drowsiness may give place to convulsive motion. The muscles of the face twitch; the child becomes rigid, as though it were about to have a convulsion. There is usually not very much thirst, but there is great prostration, so that the child seems too weak to move. Every part of the body seems to be so sore that he cries out if you move him. These symptoms will remit and, possibly, the next morning, slight perspiration will show itself. The next afternoon the symptoms return as before.

In intermittent types of fever you may select Gelsemium in the beginning. The chill runs up the back or starts from the feet and extends upward. It is sometimes associated with copious urination and with bruised aching all over the body. The patient wants to be held so that he will not shake so much. Then comes the fever with the symptoms that I have already mentioned. Sometimes irritability is exhibited. He can neither bear noise nor light. The sweat is slight or partial, but it relieves all the pains. The tongue is coated white or yellow. Speech is thick. The bowels are constipated and the stools are yellow. It is especially indicated in intermittent fever of nonmalarial origin.

In adults we find Gelsemium the remedy in bilious fever, particularly bilious remittent fever. The reason that it is useful in bilious fever is that it causes a passive congestion of the liver. The blood flows sluggishly through the liver. This is not the portal stasis found under Nux vomica, but it is a lazy now of blood. Thus the liver becomes overcharged with blood, the bile cannot be properly secreted, and there is a bilious type of fever.

In typhoid fever Gelsemium is indicated, particularly in the initial stages; when, during the first week, the patient feels sore and bruised all over, as if he had been pounded. He dreads to move. He has headache. More than that, he has loss of muscular power. He is drowsy, and has this same suffused red face. In these cases Gelsemium will so modify the course of the fever that the patient will pass through it with comparatively mild symptoms.

We may find Gelsemium indicated in catarrhs excited by warm, moist, relaxing weather, with excoriating discharge from the nose, making the nostrils and wings of the nose raw and sore. There are frequent paroxysms of sneezing, especially in the morning, and sore throat, the tonsils being red and somewhat tumefied, with difficulty in swallowing. I would remind you, in passing, that this difficulty in swallowing is not what it is under Belladonna. Under the latter remedy the difficulty comes from the extent of the swelling, and also from spasmodic contraction of the fauces, owing to the hyperesthesia of the nerves. No sooner does water touch the throat than it is expelled through the nose. With Gelsemium the d3<sphagia is the result of the paretic state of the muscles, or the patient was muscularly weak when he caught cold. With this cold you will find dry, teasing, tickling cough, with very little expectoration. There is a sensation of dryness in the mouth, although it is not dry, which reminds us of Nux moschata and Nat? tint mur. The right nostril is red and sore; there is a feeling as if hot water were passing over the mucous membrane of the nostrils; relief comes when near the fire. You find general prostration, and often, too, neuralgia of the face.

Quillaya (or soap bark) cures colds contracted in warm relaxing weather. Like Gelsemium there are muscular languor, desire for rest and quiet, general bruised feeling, even of the eye-balls, etc. The former, however, has more of a stuffed sensation in the nose; the latter a fluent, excoriating coryza with neuralgia of the face and head. Now in prosopalgia Gelsemium may be of use when the disease affects one side, and is intermitting in its type. The seventh pair of nerves is involved, and the patient makes all sorts of grimaces. Gelsemium has some slight action on the skin. It produces redness and an itching which is violent enough to prevent the patient from falling asleep. A fine eruption, consisting of small pimples, and somewhat resembling that of measles, may appear. Gelsemium may, therefore, be used in measles in the beginning, when fever is a prominent symptom, and we have the watery discharge from the nose, excoriating the alse nasi and the upper lip. There is apt to be associated with this a hard, barking, croupy cough and hoarseness.

Aconite, other things being equal, is the best remedy we have for the beginning of measles. If you have a case that you presume is going to be measles, with fever, restlessness, photophobia, coryza, sneezing, and hard, croupy cough, you are justified in giving Aconite. If there be any fever Pulsatilla is not the remedy.

When the skin is moist with the fever, Belladonna is more likely to be the remedy.

When the characteristic drowsiness and suffused face is present, you may give Gelse?niu?n in the beginning of any eruptive disease, even if there be convulsions present.

Next I want to speak of the action of Gelsemium on the genital organs. On the male organs it produces a condition very nearly approaching impotence. There are frequent involuntary emissions at night, with relaxation of the organs, no lascivious dreams, and often cold sweat on the scrotum. It is indicated especially in those cases which arise from masturbation.

I would have you note here another remedy, namely, Dioscorea. This is excellent for what we may term atonic seminal emissions. The organs are so relaxed that two or three dreams, with emissions of semen, occur in a single night. The day following the emissions the patient feels weak, particularly about the knees In these cases I know of no remedy like Dioscorea. I usually give it first in the 12th potency, and afterward in the 30th.

Caladium seguinum is indicated for the bad effects of sexual excesses, when wet-dreams occur without any lasciviousness or any sexual excitement whatsoever.

Agnus castus is the remedy for spermatorrhoea in old sinners. The parts are cold and relaxed; the sexual appetite is gone and the patient is melancholic.

Other remedies which may be compared with Gelsemiurn in its action on the male organs are Digitalis, Phosphorus , Nux vomica, Calcarea ostr. , Lycopodhim and Camphor.

Sepia, Selenium, and Conium produce a similar seminal weakness, with erethism and easy emissions.

In gonorrhoea, Gelsemium is indicated in the beginning when there is marked urethral soreness. There are also burnings at the meatus and along the course of the urethra. The discharge as yet is slight, not having become purulent. The disease may have been suppressed, and, as a result, may be complicated with epididymitis. In gonorrhceal rheumatism it may be a useful remedy.

In diseases of the female organs, Gelsemium is an invaluable remedy. First of all, we find it useful in rigid os uteri. You must not confound this condition with the more common spasm of the os, which calls for Belladonna. Often we find in labor, after it has lasted several hours, that there has been tardy dilatation of the os. The examining finger finds the os unyielding, hard and thick. The patient is hysterical and full of nervous excitement. The pains leave the uterus and fly all over the body or shoot upward and backward. At other times the pains go from before backward and the uterus seems to push upward. Or there is a sensation of a wave rising from the uterus to the throat, ending in choking. This condition calls for Gelsemium.

Another condition, exactly opposite to this, also calls for Gelsemium, namely, complete atony of the uterus. The neck of the uterus is as soft as putty. It is perfectly flabby. The body of the uterus does not contract at all. The bag of waters bulges freely from the os, but there is no attempt whatever at expulsion. In such cases, give a few doses of Gelsemium.

In the premonitory stages of puerperal convulsions Gelsemium is an admirable remedy. Albuminuria may be present. The convulsions are preceded by drowsiness, and twitching of different parts of the body. The os is either rigid, as I first mentioned, or else everything is perfectly inactive; the pulse is full and large, but soft. Sharp, distressing, cutting pains in the abdomen go from before backward and then upward, and with every pain the face flushes.

Gelsemium may also be used in the non-pregnant state. The uterus is markedly anteflexed and feels as if squeezed by a band. The uterine symptoms are associated with a frontal headache and dim vision. The head feels enormously enlarged, with a wild confused feeling in it. These symptoms alternate with sharp labor-like pain in the uterus extending to the hips and back, and even down the thighs. Gelsemium is often useful in neuralgic and congestive dysmenorrhcea when bearing down coexists.

Caulophyllum is similar to Gelsemium in dysmenorrhcea and follows it well.

Actea racemosa and Sepia have headaches reflex from uterine irritation.

Gelsemiurn is useful for the effects of emotions, particularly after fright or fear. A suddenly appearing diarrhoea, coming on from excitement, as for instance '

' stage-fright '

' or the anticipation of some trying ordeal, calls for Gelsemium. The stools are copious, yellow and papescent. The tongue is coated white or yellowish.

Other remedies coming into play in cases of diarrhoea arising from^ emotional influences are Opiu?n y Veratrum album, Argentum nitricum and Pulsatilla.

Opium in cases coming on as a result of fright, especially when the image of the thing which caused the fright constantly appears before the mind.

Veratrum album in diarrhoea after fright, associated with cold sweat on the forehead.

Argentum nitricum when diarrhoea follows great excitement, especially when the imagination has been played upon. Diarrhoea from anticipation.

Pulsatilla in diarrhoea from fright, when the stools are greenish, yellow and slimy, or very changeable and worse at night; trembling; weeping.

Gelsemium may even avert impending abortion from depressing emotions, with the peculiar pains mentioned above in connection with labor. In this condition you should compare Aconite and Opium. Conium, Physostigma and Tabacum intensify the action of Gelsemium. Gelsemium is antidoted by stimulants, and by Belladonna, Digitalis, China and Cojfea.

Desire to be quiet, to be left alone. Dullness, languor, listless. "Discernings are lethargied. " Apathy regarding his illness. Absolute lack of fear. Delirious on falling to sleep. Emotional excitement, fear, etc, lead to bodily ailments. Bad effects from fright, fear, exciting news. Stage fright. Child starts and grasps the nurse, and screams as if afraid of falling (Bor).

Yellow Jasmine Centers its action upon the nervous system, causing various degrees of motor paralysis. General prostration. Dizziness, drowsiness, dullness, and trembling.

Slow pulse, tired feeling, mental apathy. Paralysis of various groups of muscles about the eyes, throat, chest, larynx, sphincter, extremities, etc. Post-diphtheritic paralysis. Muscular weakness. Complete relaxation and prostration. Lack of muscular co-ordination. General depression from heat of sun. Sensitive to a falling barometer; cold and dampness brings on many complaints. Children fear falling, grab nurse or crib. Sluggish circulation. Nervous affections of cigarmakers. Influenza. Measles. Pellagra.

Worse, damp weather, fog, before a thunderstorm, emotion, or excitement, bad news, tobacco-smoking, when thinking of his ailments; at 10 am. Better, bending forward, by profuse urination, open air, continued motion, stimulants.

Vertigo, spreading from occiput. Heaviness of head; band-feeling around and occipital headache. Dull, heavy ache, with heaviness of eyelids; bruised sensation; better, compression and lying with head high. Pain in temple, extending into ear and wing of nose, chin. Headache, with muscular soreness of neck and shoulders. Headache preceded by blindness; better, profuse urination. Scalp sore to touch. Delirious on falling asleep. Wants to have head raised on pillow.

Hot heavy, flushed, besotted-looking (Bapt; Op). Neuralgia of face. Dusky hue of face, with vertigo and dim vision. Facial muscles contracted, especially around the mouth. Chin quivers. Lower jaw dropped.

Ptosis; eyelids heavy; patient can hardly open them. Double vision. Disturbed muscular apparatus. Corrects blurring and discomfort in eyes even after accurately adjusted glasses. Vision blurred, smoky (Cycl; Phos). Dim- sighted; pupils dilated and insensible to light. Orbital neuralgia, with contraction and twitching of muscles. Bruised pain back of the orbits. One pupil dilated, the other contracted. Deep inflammations, with haziness of vitreous. Serous inflammations. Albuminuric retinitis. Detached retina, glaucoma and descemetitis. Hysterical amblyopia.

Sneezing; fullness at root of nose. Dryness of nasal fossæ. Swelling of turbinates. Watery, excoriating discharge. Acute coryza, with dull headache and fever.

Putrid taste and breath. Tongue numb, thick, coated, yellowish, tremble, paralyzed.

Difficult swallowing, especially of warm food. Itching and tickling in soft palate and naso-pharynx. Pain in sterno-cleido-mastoid, back of parotid. Tonsils swollen. Throat feels rough, burning. Post-diphtheritic paralysis. Tonsillitis; shooting pain into ear. Feeling of a lump in throat that cannot be swallowed. Aphonia. Swallowing causes pain in ear (Hep; Nux). Difficult

swallowing. Pain from throat to ear.

As a rule, the Gelsemium patient has no thirst. Hiccough; worse in the evening. Sensation of emptiness and weakness at the pit of the stomach, or of an oppression, like a heavy load.

Diarrhœa from emotional excitement, fright, bad news (Phos ac). Stool painless or involuntary. Cream-colored (Calc), tea-green. Partial paralysis of rectum and sphincter.

Profuse, clear, watery, with chilliness and tremulousness. Dysuria. Partial paralysis of bladder; flow intermittent (Clematis). Retention.

Spermatorrhœa, without erections. Genitals cold and relaxed (Phos ac). Scrotum continually sweating. Gonorrhœa, first stage; discharge scanty; tendency to corrode; little pain, but much heat; smarting at meatus.

Rigid os (Bell). Vaginismus. False labor-pains; pains pass up back. Dysmenorrhœa, with scanty flow; menses retarded. Pain extends to back and hips. Aphonia and sore throat during menses. Sensation as if uterus were squeezed (Cham; Nux v; Ustilago).

Slowness of breathing, with great prostration. Oppression about chest. Dry cough, with sore chest and fluent coryza. Spasm of the glottis. Aphonia; acute bronchitis, respiration quickened, spasmodic affections of lungs and diaphragm.

A feeling as if it were necessary to keep in motion, or else heart's action would cease. Slow pulse (Dig; Kalm; Apoc; Can). Palpitation; pulse soft, weak, full and flowing. Pulse slow when quiet, but greatly accelerated on motion. Weak, slow pulse of old age.

Dull, heavy pain. Complete relaxation of the whole muscular system. Languor; muscles feel bruised. Every little exertion causes fatigue. Pain in neck, especially upper sterno-cleido muscles. Dull aching in lumbar and sacral region, passing upward. Pain in muscles of back, hips, and lower extremities, mostly deep-seated.

Loss of power of muscular control. Cramp in muscles of forearm. Professional neuroses. Writer's cramp. Excessive trembling and weakness of all limbs. Hysteric convulsions. Fatigue after slight exercise.

Hot, dry, itching, measle-like eruption. Erysipelas. Measles, catarrhal symptoms; aids in bringing out eruption. Retrocedent, with livid spots. Scarlet fever with stupor and flushed face.

Cannot get fully to sleep. Delirious on falling asleep. Insomnia from exhaustion; from uncontrollable thinking; tobacco. Yawning. Sleepless from nervous irritation (Coffea).

Wants to be held, because he shakes so. Pulse slow, full, soft, compressible. Chilliness up and down back. Heat and sweat stages, long and exhausting. Dumb-ague, with much muscular soreness, great prostration, and violent headache. Nervous chills. Bilious remittent fever, with stupor, dizziness, faintness; thirstless, prostrated. Chill, without thirst, along spine; wave-like,

extending upward from sacrum to occiput.

Compare: Ignatia (gastric affections of cigarmakers); Baptisa; Ipecac; Acon; Bell; Cimicif; Magnes phos (Gelsem contains some Magnes phos). Culex––(vertigo on blowing the nose with fullness of the ears). Antidotes: China; Coffea; Dig. Alcoholic stimulants relieve all complaints where Gelsem is useful.

Tincture, to thirtieth attenuation; first to third most often used.

Gelsemium

Weather: If you will observe the weather conditions in sharp climates, such as Minnesota, Massachusetts and Canada, you will find that the cold spells are very intense and that people when exposed, come down with complaints very rapidly and violently.

That is the way the Bell. and Acon. cases come on, but Gelsemium complaints do not come from, such causes nor appear that way. Its complaints are more insidious and come on with a degree of slowness.

A Gels. cold develops as symptoms several days after the exposure, while the Acon. cold comes on a few hours after exposure. The Aconite child exposed during the day in dry, cold weather will have croup before midnight. But in the South diseases are very slow. Like the people themselves, their organs are very slow, and their reaction is slow.

Their colds are not taken from the violent cold, but from getting overheated. Hence, they take colds and fevers of a low malarial type; they have congestive headaches and congestive complaints that do not come on suddenly. When we think of the climate, and consider the people, and the pace of remedies, we see that Gels. is a remedy for warm climates, while Acon. is a remedy for colder climates.

Certain acute complaints in the North will be like Aconite, while similar complaints will have symptoms in the warmer climate like Gels. The colds and fevers of the mild winters will be more likely to run to this medicine, whereas the colds and fevers of a violent winter will be more likely to run to Bell. and Acon.

It is true that Acon. has complaints in hot weather, fevers and dysentery of hot weather, but they are different from the complaints of winter.

Gels. has been used mostly in acute troubles. In lingering acute troubles and in those resembling the chronic it is very useful, but in chronic miasms it is not the remedy. It is only a shortacting remedy, though slow in its beginning. In this it is like Bryonia. Bry. complaints come on slowly, and hence it is suitable for fevers coming on in the southern climate, but it also has sudden violent complaints, though not to the extent we find in Bell.

Complaints: The complaints of Gels. are largely congestive. Cerebral hyperemia, determination of blood to the brain and to the spinal cord. The extremities become cold and the head and back become hot. The symptoms are manifested largely through the brain and spinal cord. In connection with brain affections there are convulsions of the extremities, crampings of the fingers and toes and of the muscles of the back. Coldness of the fingers and toes; sometimes the extremities are icy cold to the knees, while the head is hot and the face purple. During the congestion the face is purple and mottled. The eyes are engorged, the pupils dilated (sometimes contracted), the eyes are in a state of marked congestion with lachrymation and twitching. The patient feels dazed and talks as if he were delirious; incoherent, stupid, forgetful. It is like this in intermittent fever that gradually develops towards a congestive chill. Great coldness running up the back from the lower part of the spine to the back of the head. Shuddering, as if ice were rubbed up the back.

The pains also extend up the back. With the coldness of the extremities, the very dark red countenance, the dazed condition of the mind, the glassy eyes and dilated pupils, we have the neck drawn back and rigidity of the muscles of the back of the neck, so that the neck cannot be straightened, and there are violent pains up the back and coldness in the spine.

This state would remind one of cerebro-spinal meningitis. Pain in the base of the brain and in the back of the neck. With all states there is a very hot skin and a high temperature, with coldness of the extremities. Sometimes the troubles are ushered in with a violent chill. This is a very important remedy to study when such symptoms are present in intermittents and in a few days the tongue begins to coat, nausea comes on, ending in vomiting of bile, and instead of there being an intermission a continued fever extends from one paroxysm into another, with a higher temperature in the afternoon.

The chill practically subsides, leaving a state which has the appearance of typhoid, with dry tongue, not much thirst and marked head symptoms, dazed in mind. If this continues many days delirium and all the features of typhoid will come on and the fever will change its type altogether from the intermittent to the continued.

In congestive chill with high temperature occurring in the afternoon, the chill part of it subsiding and the fever becoming continued, Gels. is a useful remedy. It is also a very important remedy in afternoon fevers without chill in infants and in children. You will find in malarial districts that it is a common thing for the infants to have remittent attacks, while the adults are having intermittents. it is only occasionally that you will see a child or infant shake with a distinct chill, but they often go into a remittent fever, an afternoon fever which will subside along towards morning, to be followed the next afternoon by fever. With Gels. the child will lie as still as in Bry. but there is more congestion to the head there is the dark red face and duskiness like Bry.

Running through the febrile complaints, in the spinal meningitis, in congestion of the brain, in intermittents or remittents that change to a continued fever, and even in a cold when the patient is sneezing and has hot face and red eyes, there is one grand feature, viz., a feeling of great weight and tiredness in the entire body and limbs.

The head cannot be lifted from the pillow, so tired and so heavy is it, and there is such a great weight in the limbs. The Bry. patient lies quietly because if lie moves the pains are worse. He has an aversion to motion, because he is conscious that it would cause an increase of suffering. The heart is feeble and the pulse is feeble, soft and irregular. There is palpitation during the febrile state. Palpitation, with weakness and irregularity of the pulse. There is a sense of weakness and goneness in the region of the heart, and this weakness and goneness often extend into the stomach, involving the whole lower part of the left side of the chest and across the stomach, creating a sensation of hunger, like Ignatia and Sepia. There is a hysterical element running through Gels. and it has the nervous hunger, or gnawing.

There are cardiac nervous affections like Digitalis, Cactus and Sepia. Sepia is not known to be as great a heart remedy as Cactus, but it has cured many cases of heart troubles. Sepia has cured endocarditis, and a remedy that will take hold in endocarditis and root it out must be a deep acting remedy. He feels that if he ceases to move the heart will cease to beat.

The headaches are of the congestive type. The most violent pain is in the occiput, and it is felt sometimes as a hammering. Every pulsation is felt like the blow of a hammer in the base of the skull. These headaches are so violent that the patient can not stand up, but will lie perfectly exhausted, as if paralyzed from the pain. There is an occipital headache that compels walking or rolling the head.

There is commonly relief from lying in bed, bolstered up by pillows, with the head perfectly quiet The face is flushed and dusky and the patient is dazed. After the headache progresses a while, the whole head seems to enter into a state of congestion, there is one great pain, too dreadful to describe, and the patient loses his ability to tell symptoms and appears dazed; lies bolstered up in bed, eyes glassy, pupils dilated, face mottled, and extremities cold.

Gels. has also headaches of a neuralgic character in the temples and over the eyes, with nausea and aggravation from vomiting. The headache is relieved by passing a copious quantity of urine; that is, the urine which has probably been scanty becomes free and then the headache subsides. There is much nervous excitement. Complaints from fear, from embarrassment, from shock that is attended with fear, from sudden surprises that are attended with fright. A soldier going into battle has an involuntary stool; involuntary discharges from fright and surprises accompanying fright. On becoming suddenly overwhelmed by some surprise he becomes faint, weak and exhausted, he becomes tired in all the limbs and unable to resist opposing circumstances. His heart palpitates. This is similar to Arg. nit. Arg. nit. has the peculiar condition that when dressing for an opera a sudden attack of diarrhea comes on, causing more or less sudden exhaustion, and she must go several times before she can finish dressing. They who are to appear before an audience are detained because of a sudden attack of diarrhoea. A lady has an attack of diarrhoea when about to meet friends over whom she expects to become excited at the meeting. The anticipation brings on the diarrhoea. Such a state is Arg. nit. These medicines are so closely related to each other that there are times when they will appear to do the work of each other.

Then we have paralytic affections of the sphincters, and so with the febrile conditions there is involuntary loss of stool and urine. There is also paralytic weakness of the extremities and of the hands. With paralytic states there is aching along the spine and in the muscles of the back; drawing, cramping in the muscles of the back and aching under the left shoulder blade. There are many disturbances of vision; double vision, dimness of vision, appearance of a gauze before the eyes; confusion of vision and blindness. These symptoms come on before going into attacks, in connection with chill, at the coming on of sick headaches and congestive headaches. All sorts of objects are seen; the field of vision appears full of black spots, or full of smoke or little waves of various colors. It is useful in inflammation of all the tissues of the eye and of the eyelids. The eyeballs oscillate laterally when using them.

Drooping of the eyelids or ptosis is a marked feature and is in its paralytic nature. The muscles are relaxed, they do not hold the lids tip. The lids close when he is looking steadily; they simply fall down over the eyes. The patient in general is thirstless, and it is the exception that there is much thirst. It has a profuse, exhaustive sweat and is aggravated from motion, or rather motion seems to be impossible. It seems that he is unable to move, that be is too weak to move, and this runs through all complaints. At times it is a remedy for coryza, with sneezing and running of water from the nose, with coldness in the extremities, and the trouble will go down into the throat and produce sore throat, with redness, tumefaction, enlargement of the tonsils, hot head and congested face.

With this, as with the other febrile conditions, there is heaviness of the extremities. The red face, the heaviness of the extremities and sore throat that has come on gradually, a little worse from day to day, until it has become a severe throat, will lead you to Gels., especially if there is paralytic weakness all over, and as the throat trouble progresses the food and drink come back through the nose.

This is due to a paralysis of the muscles of deglutition. The tongue also becomes paralyzed and don not perform its work in an orderly way. There are times when the paralytic weakness is not sufficiently marked to account for things seen, but there is an incoordination of muscles and he is awkward. He undertakes to, take hold of an article and takes hold of something else. When he does grasp his hands feel weak. He is awkward and clumsy and the muscles do this and that and something not ordered to do. The trembling incoordination and paresis are especially noticed during high excitement and afterwards, and these states occur with the febrile condition and remain sometimes after. Useful in paralytic cases that begin with fevers. Tearing is felt in the nerves all over the body and seems to be due to an inflammatory condition. It has cured sciatica, with tearing pains, associated with great weakness of the limbs.

Loss of sensation is sometimes found; numbness of the end of the nose, of the ears, of the tongue, of the fingers, of the hands and feet, numbness, here and there, of the skin. In the male, the sexual organs arc in the same condition as the patient in general. The semen dribbles away; there is impotency, no ability to perform the sexual act; the sexual organs are relaxed.

The sleep is greatly disturbed. He cannot go to sleep; every excitement keeps him awake. During marked febrile conditions he has a profound sleep or coma. When he is not in this comatose sleep during congestion he is in a state of nervous excitement in which he lies awake thinking, and yet thinks of nothing in particular, because his!mind will not work in an orderly way. The symptoms of Gels. may be present in inflammation of any organ, uterus or ovaries, stomach, the lungs and of the rectum. It has congestion of organs, but it has also high grade inflammation. There is nothing peculiar in the inflammation itself that would indicate Gels., neither should Gels. ever be given because there is inflammation, but when the mental symptoms are present, the delirium, the flushed face, the determination of blood to the head with the cold extremities, the great heaviness of the limbs, the disturbance of sensation, the paralysis of sphincters, then Gels. would be good for inflammation of any organ of the body. In a most distressing and violent, rapidly spreading erysipelas that seems destined to cause death in a few days all the symptoms point to Gels., and though Gels. may not have produced erysipelas, it will stop the progress of the disease in a few hours and the patient will go on to a quick recovery.

Many times when erysipelas has spread over the face and scalp and in the most dangerous manner with the dusky red color that belongs to Gels., and other symptoms such as I have described in a general way, Gels. has taken bold of the erysipelas and cured. If we master thoroughly the Materia Medica we do not stop to see if a remedy produces certain kinds of inflammation, etc., but we consider the state of the patient.