Hepar sulphuris

Lax. CHILLY AND OVERSENSITIVE; to cold; to pain; or to touch; faints easily, etc. Profuse secretions; foul; like old cheese. Sour, stools, smell of body, sweat, etc. SWEATS EASILY, but dare not uncover; and profusely, without relief. As of a wind blowing on part. Wears overcoat in hot weather. Tak(e cold from damp exposure. Sore STICKING, like sharp splinters. EVERY HURT FESTERS. SUPPURATION; threatens, or much thick pus. Abscess. Mastoiditis. Yellow, sclerotic, expectoration, sweat, etc. .................... Bad temper. Sudden weak memory. Touchy, mentally and physically; to pain, cold; easily becomes cross and violent. Hasty, violent, irritable or dissatisfied. Hair falls in spots; sore to touch. Corneal ulcer or maculæ. Photophobia. Chronic otorrhœa. Boring at root of nose. Stuffed, painful nose. Ripened colds and old catarrhs. Sneezes from every cold wind. Hawks mucus. Rough sticking like a splinter, fish- bone, etc., in throat. Quinsy. The upper jaw projects. Goitre (r); pains into head. Stomach weak; easily upset. Craves acids, condiments or stimulants. Eating refreshes, but causes heaviness. Foul mucus from anus. Stool difficult, although soft. Must wait to urinate; passes blood and pus afterwards. Nephritis; after scarlatina. Very foul, hot, membranous or pussy leucorrhœa. Painful larynx. Cough from least uncovering. Whistling, choking breathing; must bend head back. Croup. Hoarseness; chronic; of singers. Aphonia. Asthma; after suppressions. Cough, choking, barking; < cold drinks or in A.M.; hacking, as from a feather; LOOSE, but can't expectorate, tightens up in cold air. WEAKNESS AND MUCH RATTLING IN CHEST. Much expectoration; thick, yellow. Recurrent bronchitis; from every cold. Skin sensitive to cool air (Agar.). Foul, moist eruptions in folds. Torpid, pulsating ulcers; encircled by smaller ones, pimples or boils. Impetigo. Poor granulation. Sweaty and rattles with every cold or cough. Night- sweats. Low fevers. Hectic. Body exhales a foul odor.

COLD, dry: AIR. WINTER. DRAFTS. WIND. PART BECOMING. LEAST: UNCOVERING. TOUCH. Noise. Exertion. Lying on painful part. Mercury. Night.

HEAT: WARM WRAPS. TO HEAD. Moist. DAMP WEATHER.

NERVES. CONNECTIVE TISSUE. RESPIRATORY MEMBRANES. Flexures. GLANDS. Kidneys. Skin. Bridge of nose (Kali-bi.).

Complementary: Iod. Sil. Related: Merc. Follows: Pho. Sil. Antidotes: Bell. Cham. Kali-io. Merc. Sil.

Hepar sulphur

Sidphuret of Lime. Ca. S.

For torpid lymphatic constitutions; persons with light hair and complexion, slow to act, muscles soft and flabby.

The slightest injury causes suppression (Graph., Mer.).

Diseases where the system has been injured by the abuse of Mercury.

In diseases where suppuration seems inevitable, Hepar may open the abscess and hasten the cure.

Oversensitive, physically and mentally; the slightest cause irritates him; quick, hasty speech and hasty drinking.

Patient is peevish, angry at the least trifle; hypochondriacal; unreasonably anxious.

Extremely sensitive to cold air, imagines he can feel the air if a door is opened in the next room; must be wrapped up to the face even in hot weather (Psor. ) ; cannot bear to be uncovered (Nux — cannot bear to be covered, Camp., Sec.); takes cold from slightest exposure to fresh air (Tub.).

Urine : flow impeded ; voided slowly, without force, drops vertically; is obliged to wait awhile before it passes; bladder weak, is unable to finish, seems as if some urine always remains (Alum., Sib).

Cough : when any part of the body is uncovered (Rhus) ; croupy, choking, strangling; from exposure to dry west wind, the land wind (Aeon.).

Asthma : breathing, anxious, wheezing, rattling ;

short, deep breathing, threatens suffocation ; must bend head back and sit up ; after suppressed eruption (Psor.).

Croup: after exposure to dry cold wind (Aeon.); deep, rough, barking cough, with hoarseness and rattling of mucus ; < cold air, cold drinks, before midnight or toward morning.

Sensation of a splinter, fish bone or plug in the throat (Arg. ^n.. Nit. ac.); quinsy, when suppuration threatens; chronic hypertrophy, with hardness of hearing (Bar., Lye., Plumb., Psor.).

The skin is very sensitive to touch, cannot bear even clothes to touch affected parts (Lach. — sensitive to slightest touch, but can bear hard pressure. Cinch.).

Skin affections extremely sensitive to touch, the pain often causing fainting.

Ulcers, herpes, surrounded by little pimples or pustules and spread by coalescing.

cracks in commissures, Cund.).

Eyeballs: sore to touch; pain as if they would be pulled back into head (Olean., Paris).

Diarrhoea: of children with sour smell (Cal., Mag. c. — child and stool have a sour smell. Rheum) ; claycolored stool (Cal., Pod.).

Sweats : profusely day and night without relief ; perspiration sour, offensive; easily, on every mental or physical exertion (Psor., Sep.).

juries of soft parts.

Hepar antidotes : bad effects of mercury and other metals, iodine, iodide of potash, cod-liver oil; renders patient less susceptible to atmospheric changes and cold air.

Compare : The psoric skin affections of Sulphur are dry, itching, > by scratching, and not sensitive to touch; while in Hepar the skin is unhealthy, suppurating, moist, and extremely sensitive to touch.

Aggravation. — Lying on painful side (Kali c.,Iod.) ; cold air; uncovering; eating or drinking cold things; touching affected parts; abuse of mercury.

Amelioration. — Warmth in general (Ars.) ; wrapping up warmly, especially the head (Psor., Sil.) ; in damp, wet weather (Caust., Nux — rev. of, Nat. s.).

Lecture LXVI — Calcarea phosphorica and Hepar

Hepar { Belladonna, Lachesis, Merc.

J Spongia, Iod., mine, Aeon., (^ Silicea, Sulphur Broi . Nervous system { { Depresses sensorium.

Irritability of all nerves.

2. Plastic exudations.

3. Suppuration.

4. Catarrhs.

5. Glands—Bones.

6. Skin.

7. Organs.

8. As an antidote to metals.

Next, we will consider Hepar sulphuris calcarea. This is really an impure calcium sulphide, containing traces of the sulphide of lime, organic matter possibly, and very likely, too, minute proportion of the phosphate of lime, since it is made from the middle layer of the oyster shell and flowers of sulphur. It is a valuable addition to the powers of lime and sulphur used separately. It possesses many similarities to and marked differences from its components.

Hepar has some action on the nerves. It is to be remembered as a drug that causes over-sensitiveness of the nervous system. Pain seems to be intolerable to the patient, and may even cause fainting. An inflamed part feels sore and bruised, and cannot bear the touch of the hand or even of a dressing. I mention this as a universal characteristic of the drug. I have often given Hepar for cold-sores in the corners of the lips when they were about to suppurate, in inflammation of the eyes and in styes and pimples, when there was present this extreme sensitiveness to touch.

Mentally, the Hepar patient is rather sad and low spirited, particularly in the evening. At times there is an impulse to suicide. While walking in the open air the patient feels discouraged and cross, and is annoyed by the recollection of all the past unpleasantnesses that have figured in his previous life. Memory is weakened so that he forgets words and localities. And this is most evident when he is particularly irritable. He is over-sensitive so that his speech is hasty. Hepar is indicated in neuralgia, particularly of the right side of the face, after the abuse of mercury and after the unsuccessful exhibition of Belladonna, which seemed indicated, particularly after exposure to dry, cold winds. In the neural'gia and other nervous symptoms Hepar belongs with Belladonna, Silicea and Sulphur. It frequently follows Belladonna, as I have told you; and from Silicea and Sulphur you may distinguish it by the other symptoms. A symptom in connection with the mental irritability of the patient that I have already mentioned is hasty speech and hasty actions. We find precisely the same symptom under Belladonna. "Hasty speech and hasty drinking" is the way the symptom reads under the latter remedy. We find it also under Lachesis, Dulca?nara and Sulphur. To show you that this is a genuine symptom, I will mention a case of hysterical mania cured by a physician on the other side of the ocean. He had this one symptom to guide him: the patient's speech was hasty and words rolled out in profusion. The clinching symptom was that she had taken a great deal of Mercury. Hepar cured the mental condition completely. We next have to consider Hepar as a remedy in inflammation. It is suited to inflammations of a croupous form and inflammation with suppuration. In all the inflammations and congestions in which Hepar is the remedy, you will find that there is extreme sensitiveness of the affected part to touch. This is so characteristic that it must be present more or less prominently before Hepar may be the remedy. The parts feel bruised and sore, like a boil. This, as I have already said, you can carry through all the Hepar inflammations. For instance, in ophthalmia, or inflammation of the eyes, or lids, you will find that the eyelids are swollen and cedematous, and sometimes, too, suppurating styes will form. With this there is a bruised, sore sensation. The patient cannot bear to have the eye touched; neither can he bear the cold air. Cold air and cold applications increase the suffering, and here you have a good indication separating it from Mercurius. Little pimples surround the inflamed eye. Similar to Hepar in this particular are: Euphrasia, which has pimples on the cheek over which the acrid tears flow, and Phosphorus, which has small ulcers around the large ones.

So again in inflammation of the ear, whether of the external auditory meatus or of the middle ear, you will find the same soreness to the slightest touch.

We find Hepar indicated in earache when suppuration impends, after Belladonna, Chaniomilla or Pulsatilla. It is seldom indicated in the beginning.

We find these same characteristics of the inflammation present in the coryza. The nose is swollen and sore to the touch, especially in the inside of the alae or wings of the nose.

So, again, in face-ache, the bones are exquisitely sensitive to any pressure. These are all illustrations of the character of the drug. I need not multiply them, because they are found in any part of the body in which inflammation occurs.

If suppuration occurs as the result of the inflammation, we have Hepar indicated and exercising a double function. If you give it in a high potency when the throbbing, stabbing pains in the affected part and the general rigor show the onset of inflammation, it may abort the whole trouble. In other cases, if you see that suppuration is necessary, and wish to hasten the process, then you give Hepar low. In tonsillitis and in boils, particularly in the former, Hepar is indicated after Belladonna when the latter does not succeed in reducing the inflammation before suppuration commences. I will simply remind you here that I have already mentioned the distinction between Bellado7i?w, Hepar, Mercurius and Silicea in this class of diseases. Now, if the inflammation becomes croupous, Hepar may be indicated, whether it be the throat, larynx, bowels or kidneys that are involved. The characteristics indicating Hepar in croupous inflammation of the larynx are these: after exposure to dry, cold winds the patient becomes hoarse, with whistling breathing. Respiration is so difficult that the child throws its head far back in order to straighten the air-passages. The cough is hard, barking and ringing, and at the same time accompanied by rattling of mucus. So sensitive is the child to cold, that the least exposure, even uncovering an arm or a foot, excites a spell of coughing. Thus you see the extreme susceptibility of the patient to cold air. Hepar is especially indicated when the cough is worse towards morning. Occasionally Hepar may be given for cough which occurs before midnight, but then it must be moist and not dry.

You will see from these symptoms that Hepar follows rather than precedes Aconite and Spongia. Aconite is indicated in the beginning of croup when there are great anxiety, high fever, and distressed breathing. I would advise you to continue the Aconitesome time after the symptoms have been relieved, because these cases are very apt to relapse.

If, however, Aconite fails and the cough gets worse the next night, Spongia is usually the remedy, especially if there are dry, hard cough, sawing respiration, little or no expectoration, and starting up from sleep choking.

If towards morning, although there is increased secretion and moist sound, the croupous symptoms still continue, then the case calls for Hepar.

Bromine usually follows Hepar when the latter is unable to remove the exudate.

Hepar was used by Kafka, in Bright' s disease following scarlatina. He was led to this by the power of the drug to produce fibrinous or croupous exudations. Hepar has succeeded in these cases many times, so that it must have some action on the kidneys. Kafka gives it after scarlatina when the urine becomes albuminous and dropsy appears. Next we have to consider Hepar in ordinary catarrhs, or what is commonly called a "cold" with aching through the body. Hepar seldom is a remedy in the incipiency, but for the advanced stage of a "cold." If it be given at the commencement, it frequently spoils the case, whether it be one of coryza or of sore throat, because it is more suitable to what has been termed '

' a ripened cold '

' when phlegm has formed. The catarrhal process may have affected the ethmoid, with boring pain in the parts and exquisite soreness. When the patient swallows, there is a sensation as if he was swallowing a fishbone, or as if there were something sticking in the throat. Sometimes he will describe the sensation to be as if there were a crumb of bread or toast sticking in the throat. This symptom allies Hepar with Mercurius, Nitric acid, Argentum nitricum and Alumina. These colds, for which Hepar is the remedy, are re-excited by any exposure. It is often indicated when the abuse of mercury has developed in the system a susceptibility to cold.

In affections of the lungs, we find Hepar indicated in two or three classes of disease. We find it called for in pneumonia, especially during the stage of resolution. It comes in late in the disease (and not in the beginning) when, during resolution, pus forms and you have present suppuration instead of the normal resolution. Heparought also to be indicated in croupous pneumonia. Here, as in all other croupous inflammations, it is called for late in the disease.

You may also give Heparsuccessfully in the treatment of that frightful disease, pulmonary tuberculosis, when, with the deposit of tubercles in one or the other apex, you have a hard, croupy cough, with production of mucus, worse in the morning. It here frequently follows Spongia. It may bring about absorption of the tuberculous deposit.

When a cold reaches the chest, Hepar does wonderfully well if the catarrh threatens to affect the capillary tubes.

A good distinction between Hepar and Antimonium tartaricum in this connection is that the latter has loose rattling mucus; the former wheezing, purring sound, as if the exudate was more tenacious. Compare also Jaborandi, which has increased production of bronchial mucus.

In glandular disease, Hepar is indicated in the stage of suppuration, when the inflammation has gone on to the formation of pus. You will find it especially useful in the treatment of bubo, whether venereal or not, especially after the abuse of mercury. Even old buboes remaining open after mercury, and discharging continually, sometimes heal under Hepar.

It is not uncommon to find cases of indigestion embraced under the name dyspepsia, which have resulted from a long course of mercurial treatment by physicians of the dominant school. Hepar, as one of the antidotes to mercury, will sometimes cure these cases. Sometimes a cure is impossible. Still, I think, relief is always obtainable from one remedy or another. We may also find Hepar indicated by dyspepsia, independently of this cause, by the following symptoms: there are usually a sour taste in the mouth and a longing for strong tasting substances, for alcoholic drinks, for wines, for acids, and for condiments of various kinds. These seem to relieve by stimulating the stomach; so it is the purely atonic form of dyspepsia in which Hepar is indicated. There is hunger, a gnawing, empty feeling in the stomach in the forenoon, a longing for something to eat. This craving for food shows the atonic condition of the stomach. At other times, although eating does him good and increases his general strength, yet it produces a fulsomeness about the stomach. He can bear no pressure about the epigastrium. Sometimes there is burning in the stomach from congestion of that organ. The bowels are usually constipated. Urging to stool is often ineffectual, although the faeces be not abnormally hard. With Bryonia the stool is large, brown and dry; it is not necessarily so with Hepar.

In Nux vomica the constipation is of a spasmodic, fitful urging and not ineffectual.

In these dyspeptic symptoms Hepar seems to be complementary to Lachests, in that both have this condition: any kind of food, no matter how wholesome, provokes indigestion.

Hepar must not be forgotten in the marasmus of children. Standing as it does between Sulphur on one side and Calcarea on the other, as a combination of these two, it is here of value. The symptoms which lead you to Hepar in the complaints of children are these: there seems to be this same weakness of digestion; they cannot manage their food, no matter how well-selected it may be. If they are old enough, they will tell you the symptoms that I have already mentioned. If you give them any strong substance, as a preparation of beef-tea, they will show signs of enjoying it very much. Diarrhoea is present, and is usually worse during the day and after eating. The stools may be greenish or slimy, undigested, or white and sour; this last is a very important symptom. The whole child smells sour. The most prominent remedies for sour stools are Magyiesia carb., next to that Calcarea ostrearum, then Hepar, and lastly Rheum.

The symptoms for Rheum are as follows: sour stool; the whole child smells sour; the stools are frequent, brown and frothy, and attended with a great deal of straining and violent pain, which makes the child shriek.

If the liver is involved under Hepar, we find soreness and stitches in the region of that organ. The stools then become clay-colored, or even white.

The same condition is found in the bladder that we have already noticed in the rectum, viz., atony of the muscular coats. Hence, when urine is voided, it passes very slowly; it drops almost perpendicularly from the meatus urinarius instead of being ejected with some force. It takes the patient some time to empty his bladder. If with this trouble of the bladder you find wetting of the bed at night, Hepar is the remedy. It is not often indicated in this condition, however.

In this vesical paresis you should compare Sepia.

The ulcers which call for Hepar are very sluggish and indolent, slow to heal. They are rather superficial and often serpiginous. The discharge is bloody and purulent, and has an odor like that of old cheese. They have this to characterize them, extreme sensitiveness of the border of the ulceration.

The action of Hepar on the skin is important. In the first place, it produces a condition of non-healing as just indicated. Every little scratch of the skin suppurates. The same is also found in Mercurius, Chamomilla, Silicea and Lycopodium. It also produces a moist eruption in the folds of the skin. There is itching, especially in the bends of the joints. When Hepar is called for in eczematous eruptions which have a purulent discharge, we find it indicated by these symptoms: after the abuse of salves or ointments containing zinc or mercury, and the eruption is worse in the morning and accompanied by itching. Ulcers bleed easily, are extremely sensitive and emit an odor like old cheese.

Hepar is an antidote to metallic poisoning generally, but especially to mercury and iodide of potassium. It also antidotes Cinchona and Iodine.

In symptoms of the skin Hepar is similar to Carbo animalis, Sepia , Psorinum, Cuprum, Thuja, Zinc, Graphites, Natrum muriaticum and Croton tigHum.

Anguish in the evening and night, with thoughts of suicide. The slightest cause irritates him. Dejected and sad. Ferocious. Hasty speech.

Hahnemann's Calcium Sulphide Suits especially scrofulous and lymphatic constitutions who are inclined to have eruptions and glandular swellings. Unhealthy skin. Blondes with sluggish character and weak muscles. Great sensitiveness to all impressions. Sweating patient pulling blanket around him. Locally, it has special affinity to the

respiratory mucous membrane, producing croupous catarrhal inflammation, profuse secretion; also easy perspiration. After abuse of Mercury. Infected sinus with pus forming. The tendency to suppuration is most marked, and has been a strong guiding symptom in practice. The lesions spread by the formation of small papules around the side of the old lesion. Chilliness, hypersensitiveness, splinter-like pains, craving for sour and strong things are very characteristic. Feeling as if wind were blowing on some part. The side of the body on which he lies at night becomes gradually insufferably painful; he must turn. Pellagra (material doses required). Syphilis after antispecific gross medication.

Worse, from dry cold winds; cool air; slightest draught, from Mercury, touch; lying on painful side. Better, in damp weather, from wrapping

head up, from warmth, after eating.

Vertigo and headache, when shaking the head or riding. Boring pain in the right temple and in root of nose every morning. Scalp sensitive and sore. Humid scald-head itching and burning. Cold sweat on head.

Yellowish complexion. Middle of lower lip cracked. Vesicular erysipelas, with pricking in parts. Neuralgia of right side, extending in streak into temple, ear, alæ, and lip. Pains in bones of face, especially when being touched. Ulcers in corners of mouth. Shooting in jaw on opening mouth.

Ulcers on cornea. Iritis, with pus in anterior chamber; purulent conjunctivitis, with marked chemosis, profuse discharge, great sensitiveness to touch and air. Eyes and lids red and inflamed. Pain in the eyes, as if pulled back into the head. Boring pain in upper bones of the orbits. Eyeballs sore to touch. Objects appear red and too large. Vision obscured by reading; field reduced one- half. Bright circles before eyes. Hypopion.

Scurfs on and behind the ears. Discharge of fetid pus from the ears. Whizzing and throbbing in the ears, with hardness of hearing. Deafness after scarlet fever. Pustules in auditory canal and auricle. Mastoiditis.

Sore, ulcerated. Soreness of nostrils, with catarrhal troubles. Sneezes every time he goes into a cold, dry wind, with running from nose, later, thick, offensive discharge. Stopped up every time he goes out into cold air. Smell like old cheese. Hay-fever (Hepar 1x will often start secretions and profuse drainage in stuffy colds).

Ptyalism. Gums and mouth painful to touch and bleed readily.

When swallowing, sensation as if a plug and of a splinter in throat. Quinsy, with impending suppuration. Stitches in throat extending to the ear when swallowing. Hawking up of mucus.

Longing for acids, wine, and strong-tasting food. Aversion to fat food. Frequent eructations, without taste or smell. Distention of stomach, compelling one to loosen the clothing. Burning in stomach. Heaviness and pressure in stomach after a slight meal.

Stitching in region of liver when walking, coughing, breathing, or touching it (Bry; Merc). Hepatitis, hepatic abscess; abdomen distended, tense; chronic abdominal affections.

Clay-colored and soft. Sour, white, undigested, fetid. Loss of power to expel even a soft stool.

Voided slowly, without force-drops vertically, bladder weak. Seems as if some always remained. Greasy pellicle on urine. Bladder difficulties of old men (Phos; Sulph; Copaiva).

Herpes, sensitive, bleed easily. Ulcers externally on prepuce similar to chancre (Nitr acid). Excitement and emission without amorous fancies. Itching of glans, frænum, and scrotum. Suppurating inguinal glands. Figwarts of offensive odor. Humid soreness on genitals and between scrotum and thigh. Obstinate gonorrhœa "does not get well".

Discharge of blood from uterus. Itching of pudenda and nipples, worse during menses. Menses late and scanty. Abscesses of labiæ with great sensitiveness. Extremely offensive leucorrhœa. Smells like old cheese (Sanicula). Profuse perspiration at the climacteric (Tilia; Jaborandi).

Loses voice and coughs when exposed to dry, cold wind. Hoarseness, with loss of voice. Cough troublesome when walking. Dry, hoarse cough. Cough excited whenever any part of the body gets cold or uncovered, or from eating anything cold. Croup with loose, rattling cough; worse in morning. Choking cough. Rattling, croaking cough; suffocative attacks; has to rise up and bend head backwards. Anxious, wheezing, moist breathing, asthma worse in dry cold air; better in damp. Palpitation of heart.

Finger-joints swollen; tendency to easy dislocation. Nail of great toe painful on slight pressure.

Abscesses; suppurating glands are very sensitive. Papules prone to suppurate and extend. Acne in youth. Suppurate with prickly pain. Easily bleed. Angio-neurotic œdema. Unhealthy skin; every little injury suppurates. Chapped skin, with deep cracks on hands and feet. Ulcers, with bloody suppuration, smelling like old cheese. Ulcers very sensitive to contact, burning, stinging, easily bleeding. Sweats day and night without relief. "Cold-sores" very sensitive. Cannot bear to be uncovered; wants to be wrapped up warmly. Sticking or pricking in afflicted parts. Putrid ulcers, surrounded by little pimples. Great sensitiveness to slightest touch. Chronic and recurring urticaria. Small-pox. Herpes circinatus. Constant offensive exhalation from the body.

Chilly in open air or from slightest draught. Dry heat at night. Profuse sweat; sour, sticky, offensive.

Antidotes: Bellad; Cham; Sil. Compare: Acon; Spongia; Staphis; Silica; Sulph; Calc sulph; Myristica. Hepar antidotes bad effects from Mercury, Iodine, Potash, Cod-liver oil. Removes the weakening effects of ether.

First to 200th. The higher potencies may abort suppuration, the lower promote it. If it is necessary to hasten it, give 2x.

Hepar Sulphur

Coldness: The Hepar patient is chilly. He is sensitive to the cold and wants an unusual amount of clothing when in cold air. He wants the sleeping room very warm and can endure much heat in the room, many degrees warmer than a healthy person ordinarily desires, He has no endurance in the cold and all his complaints are made worse in the cold. If he becomes cold in sleep his complaints come on or if he is out in the cold, dry wind, complaints come on; inflammatory and rheumatic complaints appear. The exposure of hand or foot at night in bed brings on symptoms. He wants the covers drawn close about the neck when in bed. This patient is also oversensitive to impressions, to surroundings and to pain. What with an ordinary person would only be an ache or disagreeable sensation becomes with Hepar an intense suffering.

Pains: But the pains of Hepar may be very severe, very sharp. Inflamed spots, eruptions, boils or suppurations are full of sharp pains. This is so intense that it is described at times, as a sticking and jagging like sharp sticks. The pains in ulcers are often felt like sticks; intense and sharp as if sticks were jagging the ulcer. This sensation is often expressed by the patient suffering from sore throat. Lip feels as if he had swallowed a fish bone, or stick. This is in keeping with the general character, because it is present everywhere, in inflammations, ulcers, pustules, boils and eruptions; all seem to have sticks in them or some thing jagging.

Eruptions are sensitive, to touch. This accords with the oversensitiveness of the nerves found everywhere. The Hepar patient faints with pain, even from slight pain.

Mind: This remedy belongs to patients that are called delicate, that are oversensitive to impressions. The mind takes part in this oversensitiveness and manifests itself by a state of extreme irritability.

Every little thing that disturbs the patient makes him intensely angry, abusive and impulsive. The impulses will overwhelm him and make him wish to kill his best friend in an instant. Impulses also that are without cause sometimes crop out in Hepar.

A man may have a sudden impulse to stab his friend. A barber has an impulse to cut the throat of his patron while in the chair. Mothers may have an impulse to throw the child into the fire or an impulse to set herself on fire; an impulse to do violence and to destroy. These symptoms increase to insanity and then the impulses are often carried out. It becomes a mania to set fire to things.

The patient is quarrelsome, hard to get along with; nothing pleases; everybody disturbs oversensitiveness to persons, to people and to places.

He desires a constant change of persons and things and surroundings and each new surrounding or person or thing again displeases and makes him irritated. With this irritability of temper and physical irritability there is a tendency to suppuration in parts. Localized inflammations incline to suppurate, especially in glands and cellular tissue do we have suppuration and ulcers.

The glands of the neck, axilla and groin and the mammary glands swell, become hard and suppurate. First the hard swellings with the feeling as if they had sticks jagging in them, then it becomes highly inflamed and red over the part and ultimately it suppurates, discharges and heals slowly.

The bone even suppurates and takes on necrosis and caries. Felons around the root of the nail and ends of the fingers. The nail suppurates and loosens and comes off. Sensation of splinters under the nails, even when they do not suppurate.

The nails become hard and brittle. Warts crack open and bleed, sting and burn and suppurate. Hepar is especially useful in felons in such a constitution as described, but sometimes you will have nothing more than the fact that the patient is a scrawny, chilly patient, who is always taking cold and subject to felons. I have often had to give Hepar on no better information and have known it to stop the tendency to felons. It also competes with Silica.

The patient is often scrawny, and has a tendency to enlargement of glands. The lymphatic glands are generally hard and enlarged, They are chronically enlarged without suppuration, and at any cold that comes on some particular gland may suppurate.

The catarrhal state: is general.

There is no mucous membrane exempt, but especially do we have catarrh of the nose, ears, throat, larynx and chest. The Hepar patient is subject to coryza. In some instances the colds settle in the nose and then there will be much discharge, with sneezing every, time he goes into a cold wind.

The cold winds bring on sneezing and running from the nose, first of a watery character and finally ending in a thick, yellow, offensive discharge.

Discharges: These offensive discharges smell like decomposed cheese, and this characteristic runs through the remedy.

The discharges from all parts of the body smell like old cheese. The discharges from ulcers are offensive, and have a decomposed, cheesy smell. It has discharges running through it also that smell sour, and this is also a general because it modifies all things that can be sour.

The babies are always sour in spite of much washing. Or it may be noticed by the members of the family that one of the family always smells sour, has a sour perspiration. The discharges from ulcers are sour, and also discharges from, mucous membranes. The discharge from the nose becomes copious, and causes ulceration in patches.

Throat and cough: The throat has a catarrhal condition; the whole pharynx is in a catarrhal state with copious discharge. Throat extremely sensitive to touch; pain as if full of splinters; pain on swallowing. The larynx also is painful on talking; painful as a bolus of food goes down behind the larynx, and painful to touch with the hand.

There is a loss of voice, and a dry, hoarse bark in adults, especially in the mornings and evenings. Every time he goes out in the dry, cold wind, he becomes hoarse, loses the voice and coughs. It is a dry, hoarse, barking cough. Inspiring cold air will increase the cough and putting the hand out of bed will increase the pain in the larynx or cough.

Putting the hand or foot out of bed brings a general aggravation of all the complaints of Hepar. Putting the hand out of bed accidentally when sleeping will bring on cough, and cause sneezing. The larynx has its catarrhal state, and in oversensitive children this catarrhal state becomes a croup.

Sensitive children that are exposed during the day in a cold, dry wind, or cold air, come down next morning with a violent attack of croup. The Hepar croup is worse in the morning and in the evening; evening until midnight. Sometimes cases that at first call for Aconite run into Hepar. The Acon. croup comes on with great violence, worse in the evening before midnight. The child wakes up from its first sleep with a hoarse, barking croup. A dose of Aconit may prove entirely sufficient; or it may be only a palliative. The child goes to sleep and along towards morning, or at least sometime after midnight, there is another attack, which shows that Acon. was not sufficient. Such a case will be controlled by Hepar.

When the croup comes on after midnight and the child wakes up frightened, suffocating, rouses up in bed with a dry, hoarse and ringing cough, which rings like a dry whoop, then Spongia will nearly always be the remedy, and again if Spongia palliates it and it is not sufficiently deep and there is a morning aggravation which shows that the trouble is returning Hepar follows. Acon., Hepar and Spongia are closely related to each other and they are truly great croup remedies.

Dry, paroxysmal cough from evening until midnight and sometimes lasting all night, with choking, gagging and crouping; some loose coughing in the daytime; rawness and scraping the larynx; worse in cold air or uncovering hand or foot in bed.

The catarrhal state is sometimes lower down in the trachea, and the trachea becomes extremely sore from much coughing. The patient has been coughing days and weeks and has the morning and evening aggravations; a rattling, barking cough with great soreness of the chest in an oversensitive and chilly patient.

The cough is attended with choking and gagging, even to vomiting; it is worse in the cold air, and from putting the band out of bed. He coughs and sweats. There is much sweating the whole night, without relief. Sweating all night without relief belongs to a great many complaints of Hepar. He sweats easily, so that with the cough and on the slightest exertion he is fairly drenched with perspiration.

Ears: It has catarrhal affections of the ear. A sudden inflammation comes on in the middle ear, an abscess forms, the drum of the car ruptures and there is a bloody discharge and sticking, tearing pains in the inflamed ear. There is first a sensation of stopping up of the ear, then, bursting and pressure in the ear, and then perforation of the drum.

There is also an inflammatory condition causing a discharge that is foetid, or a bloody yellow, purulent discharge, thick, with cheesy particles and smelling like old cheese.

Eyes: Hepar sometimes is bad on the oculist. When it is indicated, it cures eyes very quickly, so that the oculist does not have a very long case and it does away with the necessity for washes in the hands of the specialist. From the eyes we have the same offensive thick, purulent discharge. Inflammation of the eyes attended with, little ulcers.

Ulcers of the cornea, granulations, bloody, offensive discharge from the eyes. The eyes look red, the lids are inflamed, the edges are turned out and the margin of the lids become ulcerated. In all sorts of so called scrofulous affections, the eye conditions may be covered by Hepar when the constitutional state is present.

The constitutional state of the patient is the only guide to the remedy. Many times the eye symptoms are nondescript. You have only an inflamed eye with catarrhal discharge, and for this you could give a large number of the antipsorics; but when you go into the state of the patient and find these general symptoms, then this remedy will cure.

The general symptoms will guide to the remedy that will cure the eyes. You will see that the specialist for the eyes is often limited unless he knows how to secure all the symptoms of the patient and selects the remedy upon the totality of the symptoms.

Bladder: There are other catarrhal, conditions. Catarrh of the bladder, with purulent discharges in the urine and copious muco-purulent deposits. Ulcers of the bladder. The walls of the bladder become hardened, so that it has almost no power to expel its contents, and the urine passes in a slow stream or in drops, or in the male the stream falls down perpendicularly. No ability to expel the urine with force. It is a paresis. There is burning in the bladder and frequent, almost constant, urging to urinate. It has also a catarrhal state of the urethra that resembles gonorrhoea, and it has been a very useful remedy in chilly patients with gleety discharge of long standing. Thick discharge of a white, cheesy character. Ulcers and little inflammatory spots along the urethra.

There is a sticking sensation here and there along the urethra and when passing urine a sensation of a splinter in the urethra. Copious leucorrhoea with the same offensive, cheesy smell.

Leucorrhea: The leucorrhea is so copious that she is compelled to wear a napkin, and the napkins, I have been told by women who have been cured by Hepar, are so offensive that they must be taken away and washed at once because the odor permeates the rooms.

This horribly offensive odor that is so permeating is often cured by Kali phos. It has really one of the most penetrating of odors, so much so that when a woman suffers from this leucorrhoea the odor can be detected when she enters the room. A very important sphere for Hepar is after mercurialisation. Many old people are walking the street at the present day who have been the victims of Calomel, who have been salivated, who have taken blue pill for recurrent bilious spells, to "tap the liver," until finally they get into a state of chilliness felt, as it were, in the bone. They sweat much about the head, they ache in the bones, and every change of weather to cold, and every cold, damp spell affects them. They, are like barometers. Hepar is the remedy for that state.

They go into diseases of the bone easily and are always shivering. While they have periods of aggravation from warmth, as a general rule they are chilly subjects, and feel the cold easily. In the more acute affections of Mercury there is an aggravation from the warmth of the bed, but the old subjects who have been years ago poisoned with it get almost bloodless, and they become chilly; they cannot get- clothing enough ib keep them warm.

They become withered and shriveled, and have rheumatic affections about the joints. Then it is that the symptoms of Hepar agree and it becomes a valuable antidote to that state of mercurialisation.

Hepar is also a complement and antidote to potentized Mercury. When Merc. has been administered and has done all it can do as a curative remedy, or when it has acted improperly and has some, what mixed up the case and it is necessary to follow it with the natural complement or antidote and prepare for another series, Hepar is to be thought of as one of the natural followers of Merc. it is well known that Merc. is not followed well by Silica. Sil. does not do useful work when Merc. is still acting or has been acting.

This is the time that Hepar becomes an intercurrent remedy. Sil. follows well after Hepar, and Hepar follows well after Merc., and thus becomes an intercurrent in that series. In old syphilitic cases when the symptoms agree Hepar is a very full and complete remedy. It corresponds to the majority of symptoms of syphilis, and it only needs to correspond to the symptoms of the individual patient when he is syphilitic to be indicated. Thus in old cases who have been mercurialized, who have had the symptoms suppressed so that the disease is latent and ready to crop out at any time, Hepar will come in and have a decided effect upon the syphilis and upon the mercury.

It will straighten matters out and cause a development that will lead to clear prescribing. In this relationship to syphilis and mercury Hepar is closely allied to Staph., Asa f., Nit. acid, Sil., etc.

Especially Hepar the remedy in those cases of syphilis where great quantities of mercury have been taken, until it is no longer able to suppress the symptoms of the disease; in old cases when the syphilitic miasm attacks the bones of the nose and they sink in, or a great ulceration takes place; those cases you sometimes see walking around the street, with a big patch over the nose or over the opening that leads down into the nasal cavity.

Nose: When there is severe pain in the region of the nasal bones, the bridge of the nose is so sensitive that it cannot be touched and in the root of the nose there is a sensation as if a splinter were sticking in. For offensive discharge from the nose, foetid oezena in an old case, which has been mercurialized, who is chilly in his very bones, think of Hepar. It has cured many such cases; it has healed up the ulcers; it has cured the catarrhal state, and it has hastened the healing up of the portions of diseased bone, by hastening the suppuration and has returned the patient to an orderly state.

Throat: As we go into the syphilitic affections that lead into the throat, we find ulcers of the soft palate which eat away the uvula, small ulcers which finally unite and destroy the soft palate and then commence to work upon the osseous portion of the roof of the mouth. The odor that comes from that mouth when it is opened to show the throat is extremely offensive; very often like spoiled cheese. The medicines that are especially related, or especially useful in this form of ulceration in old syphilitics, will be Kali bi., Lach., Merc. cor., Merc. and Hepar, but in those syphilitic cases that have been mercurialized Hepar and Nitric acid should be thought of.

Nitric acid is very closely related to Hepar; it is just as chilly; it has the sensation of sticks in the throat and in inflamed parts. It has fine ulcers in the throat, upon the tonsils and in the larynx. Nitric acid competes with Hepar.

You think of the two together. Both have sensation of a fish bone or stick in the throat. The cartilages of the larynx become attacked in syphilitic affections and old mercurial affections. When the case is not of syphilitic origin but is of sycotic origin, small or large white gelatinous polypi form in the larynx and they are sore, causing loss of voice, or cracked voice; when they cause choking or uneasiness, Hepar is one of the remedies. Hepar, Calc., Arg. nit and Nit. ac. and sometimes Thuja are the remedies related to such conditions.

Genitals: Again, in the earlier syphilitic manifestations, the chancre has the feeling of a stick in it; then comes the formation of a bubo that may be either non-suppurative or a suppurating gland, associated with a chancre or a harmless ulcer upon the penis. These conditions are often indications for Hepar, when the constitutional state is present.

Hepar has also sycotic warts. It is useful in old cases of gleet; also when there is a sensation of a splinter in the urethra. In strictures and constrictions of inflammatory character during the inflammation there is a tendency to ulcerate, and with this the sensation of a stick is felt. Arg. nit., Nit. ac. and Hepar run close together for this kind of inflammation, and will cure the inflammatory stricture before it becomes a complete and permanent fibrinous stricture. It is only very rarely that you will be able with your medicines to cure a stricture after it has taken on permanency, after it is many years old, but as long as the inflammation keeps up there is hope.

I remember one very old one that was cured by Sepia. I did not know at first of its presence, but prescribed Sepia on the symptoms of the case, and the patient came back with great suffering in the urethra, and then confessed to me that he had had gonorrhoea and had been troubled for years with a stricture. That inflammation was aroused anew and after it ran its course it really left the passage clear and there was never any more trouble with the stricture.

That was a very unusual result. I have many times prescribed for patients with the utmost endeavors to do the same thing, and have cured the patient in other respects, but the stricture would remain. Remember then that Hepar has fig warts, chronic sycotic discharges, or chronic gonorrhoea, offensive, cheesy discharges, the sensation of sticks in the urethra, inflammatory stricture, which will be associated with difficulty in passing urine, to the extent that there is a weakness of the bladder and the urine falls perpendicularly.

Suppuration: Hepar has served a valuable purpose in its ability to establish suppuration around foreign bodies. For instance, a foreign body is under the skin or is somewhere unknown. Perhaps it is the tip end of a projectile after the projectile itself has been taken away, or under the nail a splinter is forming a suppuration. It is so small that it is hardly observed and it is supposed often that the splinter has been entirely removed, but an inflammatory condition starts up.

Hepar if indicated by the general symptoms of the patient hastens the suppuration and heals up the finger, for it has all such things. Silica is another remedy capable of establishing inflammation and suppuration and removes little foreign bodies that cannot be located. Of course it is understood that if the physician knows the location of a splinter, he will take such steps as are necessary to remove it, and not wait for the action of a remedy. But at times a needle point breaks off against the bone of the finger of a seamstress, or small portions of the needle may exist where they cannot be found without an immense amount of slashing which the patient refuses. Hepar or Silica will remove it. A little abscess will form and the little mite will be discharged.

Knowing that these two remedies have this tendency to establish a suppuration wherever there are foreign bodies, it is well to be reminded that if a bullet were encysted in the lungs it would be well, if the symptoms called for Hepar or Silica, to consider whether it might not be injurious to give a remedy that would establish a suppuration. It might be that the bullet is resting in a vital place, in a net-work of arteries, and it would be well not to establish suppuration in this vital region.

Deposits, of a tubercular character are often located in a place that they can easily be suppurated out, and the action of the remedy on them would be the same as a foreign body. Hence it is that Hepar, after its administration, will very often abolish a crop of boils all over the economy because in the skin there are small accumulations of sebaceous matter and these will be suppurated out.

Sulphur also does this, so that it may be well to be careful and not give Silica or Sulphur, or Hepar too often, or too high, in patients that have encysted tubercle in the lungs. Rokitansky in his numerous post-mortems found a large number of encysted caseous deposits in the lungs, in cases that had lived and outgrown these trouble; they had become encysted and therefore perfectly safe and the patient had died of something else.

It might be dangerous to administer these medicines that have a tendency to cause suppuration in such, and you should at least proceed cautiously in using them. After you have seen a great many cases you will find that you have killed some of them. If our medicines were not powerful enough to kill folks, they would not be powerful enough to cure sick folks. It is well for you to realize that you are dealing with razors when dealing with high potencies.

I would rather be in a room with a dozen negroes slashing with razors than in the hands of ail ignorant prescriber of high potencies. They are means of tremendous harm, as well as of tremendous good.

In contrast with Hepar (although Hepar is a form of Calcarea), Calc. carb. has no such tearing down nature in it. It does not establish inflammation around foreign bodies and tend to suppurate them but causes a fibrous deposit around bullets and other foreign, substances in the flesh. It causes tubercular deposits to harden and contract and become encysted.

Many excellent homoeopathic physicians have said to me, "I do not agree with you as to the danger of Sulphur in phthisical cases. I have cured cases of phthisis with Sulphur."

So have I many of them. But I did not refer to curable cases, but to those cases which are well developed and have gave symptoms. It is well to know all the elements in the case; then if you have administered a remedy and killed your patient, you know at least what you have done. It is better to know what you have done if you have killed your patient, than to be ignorant of it and go on and kill some more in the same way.