Graphites

LUMPY, THICK OR HARD (Chin. Thu.); skin, glands, tarsi, nails, scars, callosities, stools, crusts, etc. Infiltrations. EXCORIATIONS, CRACKS OR FISSURES; in angles; at margins of mucous membranes; of eyes, nostrils, mouth, finger-tips, nipples, anus, etc. Emaciation; of affected part. Scanty, foul, thin, sticky, corrosive secretions. Watery hæmorrhages. Sense of burning, numbness or deadness. Pains go to part not lain on. Fat, relaxed, chilly and costive. .................... Impulse to groan. Sad, fearsome and irresolute. Music brings tears. Brain feels numb. Burning spot on vertex. Heavy occiput. Wens. Matted, brittle or falling hair; < vertex and sides. Milk crust. Sore or cracked outer canthi. Scrophula of eyes. Pale tarsi. Ingrown lashes. Photophobia. Inflamed or dry, scaly tarsi. Scales from ears. Briny otorrhœa. Tinnitus. Hears > in a noise. Moist eruption behind ears. Dryness in ears and nose. Nose; stuffed coryza; bleeding, < before menses. Acute smell. Sensation as of a cobweb on face. Acne before menses. Barbers'itch. Lumpy goitre. Rotten taste. Dots of thick, white fur on tongue. Choking; on swallowing, from goitre, etc. Sour: taste, eructation, blood about teeth, stool, urine, odor from mouth, sweat, etc. Hunger. Averse to meats and sweets. Alternate digestive and skin symptoms. Gastric pains -burning- necessitate eating. Morning sickness during menses. Can't bear pressure about waist. Foul belching. Flatulence. Stomach > heat, hot food, eating and lying. Abdomen distended, as from incarcerated flatus. Intestinal torpor. Large, knotty, difficult, stringy, slimy coated stools; or loose, brown, lienteric and very foul. Constipation; for days (Sep.). Fissures of anus bleed and ulcerate. Stool of masses of mucus. Slender stool and urinary stream. Priapism. Sexual exhaustion. Itching of anus and pudendum; before menses. Averse to coition. Swelled (l) ovary. Cramps in various places or burning. Indurations; ovaries, mammæ, etc. Menses irregular; late, scanty, painful, etc.; cold taking, morning sickness or sweats during. Gushes of irritating, white leucorrhœa; instead of menses. Suffocation, after mid-night, > eating. Voice lacks control, > using it. Circulation irregular. Flushings. Rushes of blood to head. Bunions, < fire heat, > pressure. Can't stretch enough. Paralysed feeling in limbs. Arms and legs go to sleep. Rawness in folds of skin. Eruptions, cracked, moist and bleed easily; < on head and behing ears. Foul, acrid foot-sweat; chafes toes. Crippled, crumbling nails. IRRITABLE, DRY, rough skin, that breaks easily and exudes A GLUEY MOISTURE; < in folds - and is slow to heal. MOIST, CRUSTY ERUPTIONS. Eczema; anal, crural, palmar, etc. Wandering or recurrent erysipelas (Hyds. Rhus-t.). Eruptions, < from heat. Supersensitive to cold; it < bone- pains, coryza and stomach. Cold, wet feet. Burning coldness.

COLD. Drafts. Light. During menses. Suppressions of eruptions. Empty swallowing. Fats. Hot drinks. Warmth of bed. Scratching. Night. Wet feet.

Open air; after walking in. Eating. Touch.

NUTRITION. Circulation. SKIN: Folds. Behind ears. Angles. Flexures. Orifices. Nails. Mind. Mucous membranes. Glands. Eyes.

Complementary: Sul. Related: Ars. Calc-fl. Carbons. Fer. Kali-bi. Pul.

Graphites

Black Lead. Amorphous Carbon.

Suited to women, inclined to obesity, who suffer from habitual constipation; with a history of delayed menstruation.

^‘What Pulsatilla is at puberty. Graphites is at the climacteric.”

Excessive cautiousness; timid, hesitates; unable to decide about anything (Puls.).

Fidgety while sitting at work (Zinc.).

Sad, despondent; music makes her weep; thinks of nothing but death (music is intolerable, Nat. c., Sab.).

Eczema of lids; eruption moist and fissured; lids red and margins covered with scales or crusts.

Sexual debility from sexual abuse.

Menses : too scanty, pale, late with violent colic ; irregular; delayed from getting feet wet (Puls.).

Morning sickness during menstruation; very weak and prostrated (Alum., Carbo an., Coc.).

Leucorrhoea : acrid, excoriating ; occurs in gushes day and night ; before and after menses (before, Sep. ; after, Kreos.).

Hard cicatrices remaining after mammary abscess, retarding the flow of milk ; cancer of breast, from old scars and repeated abscesses.

Unhealthy skin ; every injury suppurates (Hep.) ; old cicatrices break open again; eruptions upon the ears, between fingers and toes and on various parts of body, from which oozes a watery, transparent, sticky fluid.

The nails brittle, crumbling, deformed (Ant. c.) ; painful, sore, as if ulcerated; thick and crippled.

Cracks or fissures in ends of fingers, nipples, labia! commissures; of anus; between the toes.

spot., Sep., Ven).

Cataleptic condition; conscious, but without power to move or speak.

Takes cold easily; sensitive to draught of air (Bor., Cal., Hep., Nux). Suffering parts emaciate.

Hears better when in a noise; when riding in a carriage or car, when there is a rumbling sound (Nit. ac.).

Diarrhoea: stools brown, fluid, mixed with undigested substances, and of an intolerable odor; often caused by suppressed eruptions (Psor.).

Chronic constipation ; stool difficult, large, hard, knotty, with lumps united by mucous threads; too large ( Sulph. ) ; smarting sore pain in anus after stool.

Children; imprudent, teasing, laugh at reprimands.

Sensation of cobweb on forehead, tries hard to brush it off (Bar., Bor., Brom., Ran. s.).

Phlegmonous erysipelas : of face, with burning, stinging pain ; commencing on right side, going to left ; after application of iodine.

Decided aversion to coition (both sexes).

Graphites follows well: after, Lyc., Puls.; after Cal. in obesity of young women with large amount of unhealthy adipose tissue; follows Sulph. well in skin affections ; after Sepia in gushing leucorrhoea.

Similar : to, Lyc., Puls, in menstrual troubles.

Aggravation. — At night, during and after menstruation.

Lecture XLVII — Carbo animalis, Graphites and Petroleum

Graphites. \ Slight erethism; then weak, relaxed, anaemic; chlorotic. Fat, chilly, costive; lymphatic glands swollen.

Skin: cracked, rhagades, fissures, herpes, eczema, oozing of scanty gluey humor.

Cicatrices are softened.

Mucous membranes: scanty secretion, cracks, fissures, etc. Graphites is not a pure carbon. Even the purest specimens of it contain some iron. You will note that I have placed beneath it two complements, namely, Arsenicum and Ferrum. It has many symptoms in common with Ferrum, acting complementary to that drug, and many more allying it to Arsenicum.

It is a relative of frerrum, principally in that class of symptoms belonging to anaemia or chlorosis of females, such as irregularities in the distribution of the blood, and pallor of both skin and mucous membranes.

It is complementary to Arsenic in many of the skin symptoms, in affections of the glands, burning in internal parts, etc. Besides these complementary remedies, Graphites has quite a number of concordant remedies. It is antidoted by Arsenicum, and in some of its gastric symptoms by Nux vomica. Arsenicum, you thus see, holds two relations to Graphites; one of antidote and one of complement. It is complementary in one series of effects, and antidotal in another. It antidotes especially the mental symptoms of Graphites.

The Graphites patient is sad and full of grief, particularly if a female. She has an anxious, apprehensive state of mind. She has forebodings of some imaginary accident or mishap which is about to take place; and this makes her anxious and restless; impelling her to move about from place to place; she cannot be kept quiet. It is this group of symptoms which Arsenicum antidotes. We find this anxious, apprehensive state of mind in Graphites to be a very important symptom. You all know how important in making a homoeopathic prescription the mental symptoms are. We find this apprehensiveness, this low spiritedness, qualifying many of the Graphites conditions. We see it in the chlorosis, in the skin symptoms, in the inflammations of the eye, etc., as you will discover later on.

We find Graphites acting best in constitutions in which there is a tendency to obesity. This obesity, I would have you remember, is not the healthy, solid flesh, that belongs to a full-blooded, strong, hearty individual, but it is of the kind which you find under Calcarea ostrearum, showing improper nutrition. The two remedies run close to each other in these fat but unhealthy individuals. The Graphites constitution is also one in which there is deficient animal heat, owing to the defective oxygenation of the blood. These patients are always cold, whether they are in or out of doors. The circulation is at first excited, followed b5^ loss of energy and consequent venous hyperaemia. Syncope readily occurs, with great anxiety. Motion is impaired and tissues are relaxed, but paralysis is not complete. In the case of chlorosis, the Graphites patient has these symptoms: there is a tendency to rush of blood to the head, with flushing of the face, exactly like that which belongs to Ferrum. The patient feels a sudden shock about the heart, and this is followed by rush of blood to the head. She thinks she has heart disease. On lying down at night, she experiences throbbing all through the body. That is not due to true plethora. The blood is decidedly "watery," and, if you were to examine it microscopically, you would find an excessive number of white blood corpuscles. The menstrual flow in these cases is too late, too pale and too scanty. The mucous membranes are apt to be pale, just as you find under Ferrum. The lips are pale. There is leucorrhoea, which is watery and quite profuse, sometimes excoriating the parts over which it flows.

Now, you may say, how are we going to distinguish this from Pulsatilla? Like Graphites, Pulsatilla has late and scanty menses, with pale or dark flow in chlorotic or anaemic patients; also in patients who are apt to be chilly, and who are low-spirited, crying at every imaginary trouble. How will you distinguish between these remedies ? The main distinction lies in this: the Graphites patient always has some skin symptoms to aid us, Pulsatilla scarcely any. The Graphites patient has a rough, harsh, dry skin, with very little tendency to sweat. lyittle pimples, whether containing pus or not, appear on the body, and are apt to be worse at the menstrual periods. While in Pulsatilla there is strong tendency to diarrhoea, in Graphites there is strong tendency to constipation. These symptoms are sufficient to always enable you to distinguish between these two closely allied remedies.

Next, as most important in our study of Graphites, I wish to call your attention to the action of the remedy on the lymphatic glands, and also upon the skin. It produces enlargement of the lymphatic glands, of the neck and of the axillae, and also of the inguinal and of the mesenteric glands. This, together with marked skin symptoms, calls frequently for its use in scrofula. Now, we find it running parallel with Calcarea ostrearum, Sulphur and Silicea in scrofulosis, particularly of children. We find the abdomen large and hard. The children thus affected suffer from diarrhoea, with stools which are. thin, offensive and contain partially digested food.

In inflammation of the eyes, of a scrofulous character, we have no remedy, not even Calcarea, Sulphur or Arsenic, that excels Graphites. The cornea is apt to be covered with superficial ulcers, or again, it may be inflamed. There is thickening of the eyelids, particularly along the edges, which are covered with scurf or scales. The lids may be agglutinated or not, but the grand characteristic which makes the choice of Graphites certain is this: the blepharitis is worse in the angles of the eye, in the canthi. If there is tendency for the edges of the lids to crack and bleed, you need not hesitate to use Graphites. The thickening of the cartilages of the lids may be so great as to produce ectropion or entropion. Then, too, the eyelashes become wild, turn in towards the ball of the eye and irritate the conjunctiva. Hardened styes may appear along the edges of the lids. Graphites also affects the vision. Letters appear double and run together. An eczematous eruption appears about the eyes, on the cheeks, on and behind the ears, on the top of the head and down the occiput. It may also be scattered here and there over the surface of the body, particularly in the bends of the joints. Behind the ears it assumes the form of intertrigo, being moist and sticky. If the child lies on its ear, the ear will be glued fast to the head. Sometimes you find Graphites indicated in phlyctenular ophthalmia. Little vesicles form on the cornea and on other parts of the eye, producing profuse, burning lachrymation. These tears are mixed with pus, which is thin, and excoriates the cheek over which it flows. The discharge from the nose, which is partly from the eye by the way of the puncta lachrymali, is also thin and excoriating, and you find cracks and crusts around the nostrils quite in harmony with the condition of the borders of the eyelids.

I would now like to mention briefly a few of the distinctions between Graphites and its allied remedies. Petroleum or coal-oil is similar to Graphites in many of its' symptoms. It has an eruption very much like that of Graphites and is particularly indicated when the most marked symptom is an intertrigo behind the ears. If the child is old enough, he will also complain of aching and other painful symptoms in the back of the head. The main distinction between the two remedies is that Graphites pictures more of a herpes and Petroleum a pure eczema.

In prescribing Calcarea ostrearum the local symptoms, particularly those of the eyes, do not help you much. They are too general. They are just the symptoms of scrofulous ophthalmia. But you would be aided in your selection of the drug by its general sj^mptoms, sweat of the head and cold, damp feet which are not prominent under Graphites. You may also remember that Calcarea ostrearum is the best remedy for the results of scrofulous ophthalmia, rather than the acute symptoms themselves. It is best suited to the opacities of the cornea and the thickening of the lids.

Arsenicum has the same burning, excoriating discharge from the eyes, but is distinguished by this: the lids are spasmodically closed. Otherwise the symptoms are provokingly similar.

Sulphur will help you when the edges of the lids are redder than natural, while under Graphites the edges of the lids are paler than they ought to be.

Euphrasia is useful in phlyctenular ophthalmia with excoriating discharge, etc. But although the discharge is excoriating under Euphrasia it is also thick and purulent, while under Graphites it is thin. Mercurius is also useful in scrofulous cases, especially when the patient is worse at night and from the heat and glare of the fire. Mercurius is decidedly preferable if syphilis complicates scrofulosis. Hepar is very similar indeed to Graphites. It is preferable when there is throbbing in and about the eye. Now even if the child is not old enough to describe its symptoms you will notice from its actions that there is pain and you will see evidence of the formation of pus; for instance, suppurating styes form on the lids. Hepar suits the suppurative process better than does Graphites. You will also notice that the Hepar child will not allow anything to press on the eye, because the parts are so sensitive.

Graphites is said to prevent the return of erysipelas when that disease becomes constitutional. The affected parts feel hard and tough, and if it be the face that is involved, are very much distorted. There are burning, stinging pains, as we found under Apis. It usually commences on the right side and goes to the left. It is particularly useful when Iodine has been abused.

Still further, you must remember the use of Graphites in the removal of cicatrices. This remedy seems to have the property of causing^ the absorption of cicatricial tissue. It was long ago noticed in workers in graphite, that wounds on the hands healed and the cicatrices disappeared very rapidly. Dr. Guernsey has made use of this property of the drug for the removal of cicatrices that form after mammary abscess. Professor Korndoerfer greatly relieved a child's eye by the remedy. The child had been operated on, and cicatrices formed which contracted more than the surgeon expected they would. Graphites so far relieved the case that the parts assumed their normal position.

We next have to speak of the action of Graphites on the digestive organs, and here it is allied particularly to the other carbons, Carbo veg. and Carbo animalis. We find the patient complaining of disagreeable taste in the mouth in the morning, as though he had been eating eggs. This symptom is more marked here than in any other carbon. The patient is worse from all meats. This symptom you find under Pulsatilla, Ferrum, and, in fact, under all chlorotic remedies. Sweet things nauseate and disgust the patient. After eating, the stomach becomes distended with wind. There is burning pain in the stomach; also a crampy, colicky pain—a real gastralgia, in fact. The patient wakes up at night gasping for breath; sudden dyspnoea, which is temporarily relieved by eating. The gastralgia is also relieved by eating. In this respect it again resembles Petroleum, Chelidonium and Anacardiwn, all of which have a similar modality. The abdomen is greatly distended from flatulence, and with this distended abdomen we have rush of blood to the head. The liver is apt to be hard and enlarged, with extreme tenderness to the pressure of the clothing after eating. The bowels are usually constipated. The characteristic stool is covered with mucus or contains shreds of mucus. That is a very characteristic symptom of Graphites, and of Cascarilla also. The patient suffers from haemorrhoids, which burn and sting; the anus is so extremely sore that the patient is very much annoyed when sitting. Fissures form in the anus. Graphites is here one of our best remedies. Now we have several similar remedies here. First, Lycopodium. This has distension after eating, with great accumulation of flatus, but the flatus is not rancid or putrid, as it is under Graphites. That is a sufficient distinction between the two remedies.

Again, we have this list of remedies: Ratanhia, Pcsonia, Nitric acid and Silicea. Ratanhia is an excellent remedy for fissure of the anus, and is to be recommended when there is great constriction of that orifice. Stools are forced out with great effort and the anus aches and burns for hours afterward.

Pcsonia is also useful for fissures of the anus with a great deal of oozing, thus keeping the anus damp and disagreeable all the time. This is associated with great soreness and smarting, and enormous haemorrhoids.

Nitric acid is also a remedy for fissure of the anus, particularly when there is a feeling as if there were splinters or sticks pricking the anus. Now Graphites is distinguished from all these by the fact that they have more or less tenesmus or constriction of the anus, while Gi'aphites has little or none.

Silicea is also a remedy for fissure of the anus. The patient tries to force a stool, but it partly decends and then slips back again. Now the mucous membranes: Graphites is useful in nasal catarrh when there is an extreme dryness of the nose. You often find this in scrofulous cases. This alternates with the discharge of lumps, or clinkers, as they are sometimes called. At other times, the discharge is very offensive and bloody. You notice how the offensive character of the discharge shows itself in these carbons. The borders of the nostrils are sore and scabby, and crack readily. Here you have a resemblance to Antimonium crudum, to Calcarea and toArum triphyllum .

The sense of smell is too acute. The patient cannot bear the odor of flowers. There is a cracking or roaring in the ears when swallowing or chewing. This tells you that there is catarrh of the Eustachian tubes. On examining the ear with the speculum, you will find the membrana tympani not perforated, but quite white. The ears are apt to be dry, and there is a lack of natural secretion (just as you found under Carbo veg.)

} with hardness of hearing, better from riding in a carriage. It is not the riding that improves the hearing but the noise made by the carriage.

Graphites may also be used in chronic sore throat with sensation as of a lump in the throat. This is worse after empty swallowing. Here it is similar to Sulphur and Calcarea ostrearum.

The cough of Graphites is not very characteristic. It is a dry cough with a great deal of strangling, making the face red and the eyes water. It is worse during deep inspiration.

On the male genital organs. Graphites acts quite prominently. We find it producing uncontrollable sexual excitement and violent erections. The most important symptom of Graphites is impotence. There is a want of sensation during coition with no discharge or semen.

It also acts on the female organs. We find affections of the left ovary with enlargement of that gland, and with scanty delayed menses, chilliness, constipation and coexistent eruptions. The uterus is displaced under Graphites. The os is far back and presses against the posterior wall of the vagina, hence the remedy is. indicated in anteflexion and in anteversion. With this, there is bearing down extending into the hypogastrium. The leucorrhcea is watery and profuse, sometimes coming in gushes. Often, with these symptoms, there exists an eczematous eruption about the vulva.

Great tendency to start. Timid. Unable to decide. Want of disposition to work. Fidgety while sitting at work. Music makes her weep. Apprehensive, despondency, indecision.

Black Lead-Plumbago Like all the carbons, this remedy is an anti-psoric of great power, but especially active in patients who are rather stout, of fair complexion, with tendency to skin affections and constipation, fat, chilly, and costive, with delayed menstrual history, take cold easily. Children impudent, teasing, laugh at reprimands. Has a particular tendency to develop the skin phase of internal disorders. Eradicates tendency to erysipelas. Anæmia with redness of face. Tendency to obesity. Swollen genitals. Gushing leucorrhœa. Aids absorption of cicatricial tissue. Induration of tissue. Cancer of pylorus. Duodenal ulcer.

Worse, warmth, at night, during and after menstruation. Better, in the dark, from wrapping up.

Rush of blood to head with flushed face also with nose bleed and distension and flatulence. Headache in morning on waking, mostly on one side, with inclination to vomit. Sensation of cobweb on forehead. Feels numb and pithy. Rheumatic pains on one side of head, extending to teeth and neck. Burning on vertex. Humid, itching eruption on hairy scalp, emitting a fetid odor. Cataleptic condition.

Feels as if cobwebs were on it. Eczema of nose. Itching pimples. Moist eczema around mouth and chin. Erysipelas, burning and stinging.

Ophthalmia, with intolerance of artificial light. Eyelids red and swollen. Blepharitis. Dryness of the lids. Eczema of lids; fissured.

Dryness of inner ear. Cracking in ears when eating. Moisture and eruptions behind the ears. Hears better in noise. Hardness of hearing. Hissing in the ears. Detonation in ear like report of a gun. Thin, white, scaly membrane covering membrane tympani, like exfoliated epithelium. Fissures in and behind the ear.

Sore on blowing it; is painful internally. Smell abnormally acute; cannot

tolerate flowers. Scabs and fissures in nostrils.

Rotten odor from mouth. Breath smells like urine. Burning blisters on tongue, salivation. Sour eructations.

Aversion to meat. Sweets nauseate. Hot drinks disagree. Nausea and vomiting after each meal. Morning sickness during menstruation. Pressure in stomach. Burning in stomach, causing hunger. Eructation difficult. Constrictive pain in stomach. Recurrent gastralgia. Flatulence. Stomach pain is temporarily relieved by eating, hot drinks especially milk and lying down.

Nauseous feeling in abdomen. Fullness and hardness in abdomen, as from incarcerated flatulence; must loosen clothing; presses painfully at abdominal ring. Croaking in abdomen. Inguinal region sensitive, swollen. Pain of gas opposite the side on which he lies. Chronic diarrhœa, stools brownish, liquid, undigested, offensive. Very fetid gas preceded by colic.

Constipation; large, difficult, knotty stools united by mucus threads. Burning hæmorrhoids. Prolapse, diarrhœa; stools of brown fluid, mixed with undigested substance, very fetid, sour odor. Smarting, sore anus, itching. Lump stool, conjoined with threads of mucus. Varices of the rectum. Fissure of anus (Ratanhia; Paeonia).

Turbid, with sediment. Sour smelling.

Sexual debility, with increased desire; aversion to coition; too early or no ejaculation; herpetic eruption on organs.

Menses too late, with constipation; pale and scanty, with tearing pain in epigastrium, and itching before. Hoarseness, coryza, cough, sweats and morning sickness during menstruation. Leucorrhœa, pale, thin, profuse, white, excoriating, with great weakness in back. Mammæ swollen and hard. Induration of ovaries and uterus and mammæ. Nipples sore, cracked, and blistered. Decided aversion to coitus.

Constriction of chest; spasmodic asthma, suffocative attacks wakes from sleep; must eat something. Pain in middle of chest, with cough, scraping and soreness. Chronic hoarseness with skin affections. Inability to control the vocal chords; hoarseness on beginning to sing and for breaking voice.

Pain in nape of neck, shoulders and back and limbs. Spinal pains. Pain in small of back with great weakness. Excoriation between thighs. Left hand numb; arms feel asleep; finger-nails thick, black, and rough, matrix inflamed (Psor; Fluor ac). Œdema of lower limbs. Toe-nails crippled. Stiffness and contraction of toes. Nails brittle and crumbling. Nails deformed, painful, sore, thick, and crippled. Cracks or fissures in ends of fingers. Offensive perspiration of feet.

Rough, hard, persistent dryness of portions of skin unaffected by eczema. Early stage of keloid and fibroma. Pimples and acne. Eruptions, oozing out a sticky exudation. Rawness in bends of limbs, groins, neck, behind ears. Unhealthy skin; every little injury suppurates. Ulcers discharging a glutinous fluid, thin and sticky. Swelling and induration of glands. Gouty nodosities. Cracks in nipples, mouth, between toes, anus. Phlegmonous erysipelas of face; burning and stinging pain. Swelling of feet. Wens. Chronic Poison Oak.

Complementary: Argent nit (follows well in gastric derangements); Caustic; Hep; Lycop; Ars; Tuberc. Compare: Petrol; Sep; Sulph; Fluor ac. The associated constipation with mucus- covered stools and gastric flatulency should be taken into consideration and differentiate it from such remedies as Petrol and Lycop (Raue). Antidote: Nux; Acon; Ars.

Sixth to thirtieth potency. Locally as a cerate, in sore nipples.

Graphites

The complaints of Graphites are worse morning, evening and during the NIGHT, especially before midnight. It is useful in people who are morbidly fat, or have been fat and are now emaciating; with constipation more commonly than diarrhoea; in women in these conditions whose menstrual habit is pale, late, short and scanty; catarrhal discharges that are albuminous and viscid represent to the mind some peculiar general states of the sick man not explainable and not common to diseased conditions nor to many remedies; hence, strange, rare and peculiar. Raw surfaces upon the skin are generally marked by such viscid glutinous discharges.

It is a very deep acting remedy, like all carbons, and is accompanied with induration and burning in the base of the ulcers, inflamed tissues and old cicatrices; hence, its great usefulness in cancerous growths and ulceration.

Cancerous development in old cicatrices is a strong feature of this remedy. Contraction of tendons, especially behind the knee. It has hemorrhagic oozing of pale blood. In the higher sense the patient is anaemic and chlorotic. From eruptions, catarrhal discharges, menstrual flow, ulcers, breath and perspiration there is marked offensiveness (like Carbo v., Psorinum, Kali phos., Kali ars.).

When eruptions or discharges have disappeared suddenly from any cause and grave chronic phenomena have followed Graphites is one of the medicines to be studied. Scrofulous conditions and swelling of glands; recurrent herpes upon all parts of the body and especially about the anus and genitals; burning in many parts and especially in old cicatrices; general dropsical tendency; weakness in muscles and tendons after straining them by overlifting.

Modalities: The patient is very sensitive to cold and needs warm clothing; he is sensitive to the cold in winter and to the heat in summer; he is sensitive to a warm room and desires open air which is grateful. Worse in a warm bed; complaints come on from becoming cold or heated; the headaches are worse in a warm room and better in the open air. Graphites has cured deep seated spinal complaints, and in such cases the patient delights to lie heavily covered in a cold draft from an open window.

It is easy to see in this, the resemblance to Carbo veg., which often cures when the patient wants to be fanned. Craving for air is strong in the carbons, yet often easily chilled and just as easily overheated and complaints that come from overheating are related to the carbons. This one becomes ill from being overheated; exertion makes all symptoms worse.

Motion increases all symptoms except the numbness and general feeling of stagnation which come on during rest. Extreme weakness. Weakness and desire to lie down. Paralysis in any part but especially in the lower limbs; sensation of paralysis or stagnation creeps over the body and limbs.

He is made sick by bathing and is sensitive to cold, damp weather. What there is in the general life to cause eruptions to come out in the bends of the joints must be left for others to explain, but such is the case with this wonderful remedy.

Convulsions: The same may be said of rawness and excoriation in the same regions. Cataleptic conditions are very marked in which the patient is conscious but without power to move or speak; tremulous sensation throughout the body; sudden sinking of strength; sudden weakness. Constriction in many parts. It has cured many kinds of convulsions. It is not the remedy for the convulsion, but in chronic sickness where the convulsion is but one of many elements it is often suitable. It has cured epilepsy and hysterio-epilepsy and epileptiform spasms many times when the totality of symptoms furnished the basis for the prescription.

A careful comparison of the symptoms shows that this remedy acts predominantly on the left side of the body. The patient is oversensitive to pain and outer parts are very sensitive.

Pains: The pains are burning, drawing, pressing. Soreness. Stitching and tearing. Numbness is more characteristic than pain. The formation of fissures in all the commissures and in the anus with cracked and bleeding skin in many parts with much hardening; the tendency to grow wens on the scalp and elsewhere are features of this remedy not to be overlooked, and when coupled with the mental symptoms form such a strong and striking image of perverted vital action that the neophyte should not overlook Graphites.

It is as broad and deep as Sulphur, showing the great similarity to this great remedy in chronic cases.

Mind: The patient becomes very restless when attempting close mental work and there is a marked dread of mental work. The mental depression is extreme, and it is made worse by music; her sadness is so great that she thinks only of death and salvation. Grief and vexation cause of recurrence of all her distressing mental sufferings.

Her moods are constantly changing; while she may recall all the events of youth, recent events are forgotten; slow of thought and weakness of mind worse in the morning; often excited, hurried and exhilarated in the evening; extremely fretful and impatient; irritable about trifles and very critical. Irresolution is a marked symptom.

She cannot make, up her mind to do or not to do. Extreme activity of mind in the evening and first half of the night, which, prevents sleep until midnight; apprehensive and distressed in the. morning and excited. in the evening; extreme anxiety even to desperation.

Vertigo in the morning on waking; in the evening; on looking upwards; on rising from stooping; compelled to lie down; with inclination to fall forward.

When the above general symptoms strongly predominate in any given sickness the following particulars will be cured by this remedy. Hyperaemia of the brain in the evening in a warm room; frequent moments of congestion to head and face with faint feelings; numbness felt in whole head; burning spot on the vertex; drawing, pressing and tearing in forehead over the eyes; stitching pains in the temples; pain from temples to side of face and to shoulders; one-sided headaches in the morning on waking; tearing in one side of head extending to teeth and side of neck; pressing pain on the vertex and occiput; compressing, constricting pain in occiput and back of neck; pain as though the head were numb; violent headaches during menses.

Head: The headaches are brought on from becoming cold and from looking into a bright light; are worse in a warm room, and better in the open air. There is marked soreness in the scalp; itching of the scalp with or without eruptions; eczema of the scalp oozing a glutinous fluid; eczema behind the cars; fissures that bleed behind the ears; scaly eruptions on scalp; falling out of the hair; bald, shiny patches on the scalp.

Eyes: Extreme photophobia in the sunlight with copious lachrymation. No remedy has photophobia more marked than Graphites. Pain in the eyes and over the eyes by looking long toward a sun lighted window; complaints from eyestrain.

Letters appear double when writing, letters run together when reading; flickerings and fiery zigszags just outside the field of vision in the evening; misty vision; vanishing of sight during menses.

Burning, pressing, stitching pains in the eyes. It has cured ulceration of the cornea. Recurrent pustular inflammation of the cornea. Keratitis pustulosa in children with fissures in the canthi, extreme photophobia and eczema on the face. Marked congestion and injected veins of the conjunctiva. Chronic lachrymation in open air, tears acrid. The fissured canthi bleed easily and itch violently. Purulent discharges from the eyes; the lids are stuck together at night; the eyes feel hot; the lids are much swollen and the margins are red, raw and bleed easily-sometimes hard; ulcers on the; margins of lids; the lids are covered with crusts; eczema of the eyelids and about the eyes; dry mucus in the lashes, styes on the lids, with drawing pain, especially when they recur frequently. Cystic tumors on the lids.

Ears: Discharge from the ear of sticky, viscid pus; bloody, offensive.

Noises in ears; cracking; bumming; hissing; ringing; rushing, roaring; reverberations. Violent roarings at night and the ears feel stopped; thundering, rolling sounds in ears.

Deafness in various degrees and he hears better in a noise. He can hear better when riding on the cars, in the roaring of the train.

Deafness with eczematous eruptions on and behind the ears. Stitching pains in ears in cold air. Marked swelling of the ears.

Nose: Smell very acute; she cannot tolerate flowers; loss of smell with dryness in the nose; with coryza. Discharge from nose bloody mucus or pus, very offensive, viscid, thick, sometimes yellow.

It is a most useful remedy in chronic nasal catarrh. Very painful dryness in the nose. The bones and cartilages of the nose become very sore to touch. Sneezing and fluent coryza as marked as in Carbo veg.

Frequent attacks of coryza all winter, worse in cold air; the coryza extends to larynx, like Carbo veg; the excoriated, sore, cracked nostrils are plugged with scabs and hard mucus far up in the nose. Ulcers in the nose. Fissures in the nostrils that burn and indurate.

Face: The face is pale, waxy and sickly. Eczema and herpes are found on the face with glutinous moisture. Itching with or without eruptions. A sensation as of a cobweb on the face. The commissures of mouth are fissured and the fissures ulcerate and the edges become bard and there is great burning in them. The skin chaps and cracks and often becomes excoriated and bleeds. Erysipelas of the face, spreading from right to left. The beard falls out. Crusts form on the lips and the chin is covered with eczema. The submaxillary gland is swollen and indurated.

Mouth: The gums are settling away from the teeth; the teeth burn and sting; drawing pain in teeth in cold wind; tearing in teeth worse from warmth.

Taste in the mouth is bitter, salty, sour and like spoiled eggs; nauseating taste in the morning; sour taste after eating. The tongue is coated white; burning blisters on lower lip and on tip of tongue, painful ulcers on under surface of tongue, putrid odor from gums and mouth; breath smells like urine.

Dryness of the mouth in morning on waking; also in the night on waking; saliva flows from the mouth during the night.

Throat: Chronic sore throat with ulceration and swelling; swollen tonsils; nightly pain in throat; copious white, viscid mucus; a continuation of the nasal and post nasal catarrh.

Constant choked feeling or constriction in the throat that makes swallowing difficult. Constant spasms in the throat compelling swallowing.

Stomach and abdomen: Ravenous appetite. Violent thirst in the morning with dry mouth and internal fever. Aversion to meat; to cooked food; to fish; to salt, to sweets. He is driven to eat to relieve a feeling of suffocation and burning gnawing in the stomach.

Pain in the stomach, relieved by eating. Eructations bitter; sour; putrid; tasting of food eaten; of greenish water. Rancid heartburn after eating; nausea much of the time during menses, with trembling; vomits all she eats; vomiting, purging and cold sweat.

The stomach feels constantly in a spoiled state or as from indigestion. Flatulence is as marked as in Carbo veg., and the relief from belching is just as great. Burning, constriction, pulsation and cramping are frequent symptoms. Fullness, distension, pressure are constant features of Graphites.

Retching on swallowing food (like Merc. c.). Gastric catarrh with internal heat drive him to eat and drink. Gastric pains worse from cold drinks and better by warm milk; periodical gastralgia with vomiting of food soon after eating. It is a wonderful remedy for old drunkards when the gastric symptoms agree (like Carbon bisulphide).

It is a most useful remedy in hard, swollen, sore liver with weight and distress in the liver; stitches in both hypochondria, burning in left hypochondrium when lying on it; sensitive to clothing in the liver region. Great suffering in the abdomen from flatulence; incarcerated flatus causes cramping pains, distension, and a continual source of distress.

Everything eaten seems to ferment and turn to gas; rumbling and movements felt in the abdomen; there is great burning and griping; cramping in the abdomen soon after eating; the clothing distresses the abdomen. The slightest indiscretion in eating causes increased flatus, rumbling and diarrhoea; the abdomen is distended with dropsy. Herpes zona oil the side of abdomen; herpes over lower abdomen and groin; hard swelling of inguinal glands; oedema of the abdominal walls.

Anus and stools: From the anus there is copious discharge of very offensive flatus day and night. While diarrhoea is not so common as constipation, yet it is a marked condition in some patients, The diarrhoea is painless with much flatus, with watery, brown, putrid, lienteric stools; excoriating stools, extreme soreness of the anus; fissures of the anus; great burning. Chronic diarrhoea; from the slightest indiscretion in eating on comes a renewed attack.

With the loose stools, and with the constipated stools copious white jelly-like mucus is often found. Discharge of mucus from anus and a constant moisture about the outside parts. Large hemorrhoids extremely sore with fissures. Constipation with large, hard, knotty, difficult stools passed with extreme pain from soreness and fissures of the anus. Long narrow stools (like Phos.). Violent burning in the anus, prolapsus of the anus.

It has cured many cases of bleeding piles of long standing where there was extreme soreness and fissures and great burning. Violent pains during stool. No desire to go to stool for many days. It requires a long time with hard straining to pass the stool.

It often suits patients who have no stool except by injection or cathartic. Violent itching of the anus; eczema and herpes near the anus or involving the anus. It has cured the stomach and abdominal conditions that favor the tapeworm.

Genitals and urines: The urine flows in a feeble stream, becomes very putrid after standing and deposits much red or white sediment; after standing the urine is covered with an iridescent cuticle.

After urination there is some dribbling; burning in the urinary passages and neck of the bladder when not urinating; pain in the sacrum and coccyx when urinating.

Violent sexual excitement and nightly emissions; the excitement is so strong that ejaculation comes instantly after intromission. The opposite state is also found where there is aversion to coition and erections are wanting. It is a most useful remedy for impotency following secret vice and sexual excesses. Emissions with feeble erections.

Herpes on the prepuce; excoriated and fissured glans penis; dropsical swelling of the scrotum and penis, hydrocele in small boys and baby boys. Itching and moist eruptions on the scrotum. It has cured gleety, viscid discharge from the urethra. It has cured swollen testes. In the female it causes aversion to coition; enlarged, hard ovaries great tenderness in uterus and ovaries. It has cured ovarian tumor. Pain in the uterus when reaching high with hands; bearing down in uterine region.

It cures cauliflower excrescence of the uterus; it has restrained the growth of cancer in the cervix uteri, when there was burning and putrid bloody discharge; in this it resembles Carbo an. Menses late, irregular, scanty, pale or mixed with scanty dark, small clots, short duration. Menses six or eight weeks apart.

Menses suppressed or very late in chlorotic girls. First menses delayed. Leucorrhoea instead of the menses (Cocculus). Oedema of the vulva. Leucorrhoea in gushes day and night. Dryness and heat in the vagina; coldness in the vagina. Extreme lassitude during the menses. Many symptoms come during menses; dry cough, copious sweat; oedema of feet; hoarseness; coryza; headache; nausea; morning nausea. Violent itching of the vulva before menses; marked excoriation of the genitals and between the thighs during menses; excoriating leucorrhoea before menses.

Leucorrhea white; yellowish-white; thin; viscid; offensive. Sore, cracked nipples in nursing women. Cancer of the breast coming in the cicatrix of an old cancer.

Larynx and cough: sensitive to touch.

Hoarseness in the evening (like Carbo veg.). Dryness in the larynx in the night; copious glutinous mucus in the daytime.

He suffocates when falling asleep (like Lachesis) and often wakes up in the night gasping for breath; constriction of the chest.

Paroxysmal cough like whooping cough, cough is followed by expectoration of copious white viscid mucus; paroxysms come at any time It has cured whooping cough. Cough from tickling in the larynx or trachea; violent night cough; deep inspiration causes cough.

Rawness in the trachea; stitching pains in the chest.

Constriction of the heart; electric shocks in the heart; palpitation on motion or exertion with strong pulsation all over the body and in the extremities, pulse full and heard, slow during day but fast in the morning; fast pulse in evening after eating, with fever. Itching herpetic eruption on the chest; herpes zona on left side of chest with pain. It is a useful remedy to ward off phthisis.

Enlarged hard painful glands of neck. Painless swollen glands of neck. The spine is very sensitive to the jar of the bed; pain in lumbar region as if "spine were broken "; pain in sacrum with numbness down the limbs; pain in sacrum and coccyx while urinating; itching and moisture over the coccyx.

Drawing and tearing pains in limbs; weakness of all limbs; sensation of paralysis of limbs; herpes and eczema on the limbs; marked numbness of the upper limbs, during rest and when lain on; numbness and coldness of fingers and hands.

Skin: Rheumatic and tearing pains in shoulders, worse in left.

Herpes in axilla and bend of the elbow; horny callosities on the palms; skin of the hands hard, fissured, hot and bleeding. Psoriasis of the hands and fingers; raw, moist places between the fingers; the finger nails thick and brittle; the finger nails become black and fall off. Great heat of palms.

Smarting and sore between the nates; excoriation from walking. Many eruptions on the thigh, but especially herpes and eczema; eruptions that ooze a glutinous fluid. Numbness of lower limbs during rest; the legs are weak and heavy as if paralyzed; oedema of the legs and feet.

Herpes in the groin and hollow of the knee. Cold feet in evening in bed; copious, offensive sweat of the feet; ulcers on the feet and legs; tearing in thighs, legs, feet and toes; burning heat in soles and heels; gouty-tearing in the toes; spreading blisters on the toes that become ulcers; the toenails become black; thick; and crippled toenails the nails are painful; ingrowing toenails. Dreams vivid; anxious, horrible, vexatious. Sleepless before midnight; sleepiness during the day. Nightly pains in sleep. Frequent waking. Unrefreshed in the morning.

Graphites should be used more frequently in chronic recurrent intermittent fever. Chill in the evening with tearing in the limbs chill intermingled with the fever; wants to be covered in all stages chill worse after eating, better after drinking and in open air. Nightly fevers with chilliness but no sweat; dry beat evening and night, especially before midnight; anxiety and restlessness during the fever, hands and soles very hot; even burning heat.

It has chill with fever followed by sweat; sweat from slight exertion; sweat on front of body; the sweat is offensive, cold and stains yellow; copious night sweats in weakness and during phthisis; entire inability to perspire, in many chronic complaints.

Itching of the skin all over the body, with or without eruptions itching worse at night in the warm bed; itching and burning with eruptions; the skin is very hot at night; excoriation of the skin in the bends of joints.

Every injury festers. Fissures on ends of fingers, on nipples, labial commissures at anus and vulva, between the toes. Itching blotches. Erysipelas beginning in face and spreading to other parts; erysipelas beginning in face and going from right to left.

Itching over varicose veins; itching piles. Herpes and eczema oozing a glutinous moisture. Crusty and scabby ulcers. Hard, painful cicatrices; old ulcers with proud flesh and burning, itching and stinging ulcers with indurated base and margins.