Ipecacuanha

breath accompany most complaints. Infantile convulsions. .................... Cries, screams and is hard to please. Downward crushing in head, to root of tongue. Migraine. Occipital pain, < vomiting, during chill, etc. Gushes of tears. Conjunctivitis. Cold (r), ear. Nosebleed. Sneezing. Face pale; blue about eyes or lips; white linea nasalis. Clean or red, pointed tongue. NO THIRST. Sudden faintness. HORRID NAUSEA; not > vomiting. Vomiting; bilious; < stooping. Repugnance to food. Miserable sinking or hanging loose feeling at stomach. Griping, clawing or cutting at navel; toward uterus. Brown, grass or yellow-green, molasses-like or bloody stools. Balls of mucus in stools. Dysentery. Urging to urinate; bloody urine. Cutting in uterus (l to r). Uterine hæmorrhage; gasps with each gush of blood. Painless hoarseness. Larynx and chest tight, < least motion. Spasm of vocal cords. Gasps for breath. Asthma. Paroxysms of retching, incessant or SUFFOCATIVE cough; with every breath; stiffens out, turns red or blue and finally is nauseated, gags or vomits; < stepping into open air; > warmth and repose. Pertussis. LOOSE (coarse) RATTLE IN CHEST, WITHOUT EXPECTORATION. Broncho-pneumonia. Hæmoptysis. Pains from kidneys into thighs. Short chill; alternates with heat or with external heat (Ap.). One hand cold, other hot. Long heat; without thirst. Hands and feet drip cold sweat. Suppressed or mixed intermittents; nausea in all stages. Catarrhal or gastric fevers.

WARMTH; damp. Room. Overeating: Ices. Pork. Veal. Mixed or rich foods. Periodically. Quinine. Heat and cold. Recessions.

Open air. Profuse secretions. Foamy discharges, stool, etc. CONTINUOUS NAUSEA, gastric disturbances, BRIGHT RED, GUSHING HÆMORRHAGE (rapidly clotting), or shortness of

MUCOUS MEMBRANES: DIGESTIVE. Stomach. RESPIRATORY. Lungs. Nerves: Pneumo-gastric. Spinal. Cutaneous. Umbilicus.

Complementary: Ars. Cup. Related: Ant-t. Lob.

Ipecacuanha

Ipecac. Rubiacccc.

Adapted to cases where the gastric symptoms predominate (Ant. c.. Puls.) ; tongue clean or slightly coated.

In all diseases with constant and continual nausea.

Nausea: with profuse saliva; vomiting of white, glairy mucus in large quantities, without relief; sleepy afterwards; worse from stooping; the primary effects of tobacco; of pregnancy.

Stomach: feels relaxed, as if hanging down (Ign., Staph.) ; clutching, squeezing, griping, as from a hand, each finger sharply pressing into intestines; worse from motion.

Flatulent, cutting colic about umbilicus.

Stool: grassy-green ; of white mucus (Colch.) ;

bloody; fermented, foamy, slimy; like frothy molasses.

Autumnal dysentery; cold nights, after hot days (Colch., Merc.).

Asiatic cholera, first symptoms, where nausea and vomiting predominate (Colch.).

Haemorrhage : active or passive, bright-red from all the orifices of the body (Erig., Mill.) ; uterine, profuse, clotted; heavy, oppressed breathing during; stitches from navel to uterus.

Cutting pains across abdomen from left to right (Each. — from right to left, Lyc. ).

Cough; dry, spasmodic, constricted, asthmatic.

Difficult breathing from least exercise; violent dyspnoea, with wheezing and anxiety about the stomach.

Whooping-cough ; child loses breath, turns pale, stiff and blue; strangling, with gagging and vomiting of mucus; bleeding from nose or mouth (Indigo).

Cough, with rattling of mucus in bronchi when inspiring (Ant.t.) ; threatened suffocation from mucus.

Pains as if bones were all torn to pieces (as if broken, Eup. ).

Intermittent fever: in beginning of irregular cases;

with nausea, or from gastric disturbance ; after abuse of, or suppression from quinine.

Intermittent dyspepsia, every other day at same hour; fever, with persistent nausea.

Oversensitive to heat and cold.

Is followed well : by, Ars. in influenza, chills, croup, debility, cholera infantum; by Ant. t. in foreign bodies in larynx.

Similar: to. Puls., Ant. c., in gastric troubles.

Aggravation. — Winter and dry weather; warm, moist, south winds (Euph.) ; slightest motion.

Lecture XXXVI — Ipecacuanha and Coffea

Ipecacuanha.

' Bry. , Puis., Nux v., Cinch.

Ant. crud., Tabacum.

Ars., Ant. tart., Veratr. alb.

Ipecacuanha. \ ^obelia infiata - V Cuprum met.

>Tabacum, Ars., Nux v.

Ipecacuanha ckphaeus is a small shrub growing in Brazil. It is bitter, acrid and nauseous, and possesses a peculiar odor which, in some persons, excites sneezing and even asthma. In many cases the conjunctivae are injected, with puffiness under the eyes, profuse coryza and tension over the eyes.

Ipecacuanha contains as its active principle a substance called Emetin, which gives to the drug its property of producing vomiting. It also contains an acid called Ipecacuanhic acid, and a small quantity of a foetid volatile oil. The latter constituent probably has something to do with the action of the drug on the pneumogastric nerve and its consequent use in the treatment of asthma. Ipecacuanha is easily studied. It acts upon the nerves (especially the pneumogastric) and mucous membranes. It has been employed by allopathic physicians as an anti-spasmodic in asthma and in pulmonary catarrhs. In the latter class of troubles it is used to provoke vomiting, and, of course, gives temporary relief.

Ipecacuanha seems to have a special affinity for the mucous membranes lining the bronchial tubes and alimentary canal. One of the most prominent features of this drug is its property of producing nausea and subsequently vomiting. So prominent is this symptom that you will find it present in almost all the cases in which Ipecacuanha is required.

Studied more particularly, Ipecacuanha is found suitable for patients who are easily irritated, full of desires, but know not for what. If a child, the patient cries and screams almost continually. As an adult, he is irritable and morose, holding everything in contempt. Thus you will find Ipecacuanha indicated in headaches. These are of rheumatic origin. The characteristic sensation is a pain as if the head or bones of the head were bruised or crushed, this feeling seeming to go down into the root of the tongue. This headache is accompanied by nausea and vomiting. Ipecacuanha may also be used in unilateral sick headaches with deathly nausea. In these cases the face is usually pale, blue rings surround the eyes, and the expression about the mouth betrays the intensity of the nausea. Now, these symptoms are not so necessarily present in the adult as they are in the child. You see the corners of the child's mouth drawn, and a line extending from the alse of the nose to the corners of the mouth, giving to the child an expression of nausea, and at once suggesting to your mind such remedies as Ipecacuanha, Antimonium tartaricum and especially SEthusa cynapium.

In that bursting headache of Ipecacuanha compare Veratrum album, which has that bruised feeling here and there in the brain. There is still another drug which has this symptom, and that is Ptelea. The gastric symptoms of Ipecacuanha, in addition to those already mentioned, are such as would call for the exhibition of this drug after indulgence in rich food, such as pastry, pork, fruits, candy, ice-cream, etc. Nausea is constant with all complaints; vomiting of bile; vomits just after eating (like Arsenicum); vomits after eating rich or indigestible food; vomiting of mucus; morning sickness. The tongue is usually clean, a symptom which differentiates Ipecacuanha from Nux vomica, Antimonium crudum, etc. Distress in the stomach; it feels relaxed as if hanging down (like Staphisagria, Theine, Lobelia, Tabacuni) .

These gastric symptoms of Ipecacuanha should be compared with those of three other remedies, the most important of which is Pulsatilla. You will at once recognize the similarity of the two drugs. They are both useful for gastric disturbances caused by indulgence in mixed diet, pastry, ice-cream, pork, fatty food, etc. Pulsatilla may be considered the better remedy of the two early in the attack, when the stomach still contains the food which disagrees, while Ipecacuanha is better when the stomach is empty and the effects only of the indulgence remain. The best distinction between the two remedies, however, lies in the condition of the tongue. In Ipecacuanha, the tongue, as above stated, is clean or only slightly coated, whereas in Pulsatilla the tongue is almost always foul, white or yellow, with a very disagreeable taste in the mouth.

Arsenicum album must follow or supplant Ipecacuanha, when an actual catarrh of the stomach has been produced by indigestible food, especially after sudden chilling of the stomach with ice-cream or ice-water. There are vomiting, burning pains in the stomach, diarrhoea, restlessness, etc.

Antimonium crudum, like Ipecacuanha, is suitable for gastric catarrh, following a mixed diet of pastry, etc. The tongue is thickly coated white, as if it had been whitewashed.

Ipecacuanha may be indicated when, in the case of children, indulgence in rich food has produced convulsions. It may even be useful in the convulsions of teething children, or convulsions following suppressed eruptions, cold, etc. They are of the rigid tetanic form. Sometimes the rigidity alternates with flexing of the arms and jerking of the arms toward each other.

Colic may occur, and this is of a griping character. Either the pain is situated about the umbilicus, as though a hand were tightly clutching the intestines; or the colic consists of cutting pains which shoot across the abdomen from left to right. The stools are either green, as in diarrhoea of infants, or they are yellow and liquid, and covered with mucus and blood. Sometimes they have a fermented appearance and look like molasses. That is as good a comparison as I can give you; the stool looks just like molasses when it is frothy. At other times the stools are black from admixture of bile. Some of these diarrhoeas are associated with tenesmus, indicating catarrh of the lining membrane of the bowels.

Ipecacuanha is frequently indicated in the commencement of cholera infantum. You find present pallor of the face, with blue rings around the eyes; the fontanelles are still open, showing defective nutrition; the child may have nose-bleed with the pale face; it is drowsy, with starting and jerking of the muscles during sleep. The child is subject to frequent attacks of nose-bleed. The condition already simulates that of hydrocephaloid. You must not think because Ipecacuanha is associated so closely with stomach symptoms, that it cannot be indicated in this reflex cerebral state. You will find nausea and even vomiting usually present. The child eats or drinks and vomits what it has taken almost immediately afterward. Particularly is Ipecacuanha indicated in these cases as a remedy preceding the exhibition of Arsenicum album. Arsenicum, as already indicated, is complementary to Ipecacuanha in these abdominal affections.

In some of these cases of gastro-intestinal troubles in children Ipecacuanha and the other remedies just mentioned will sometimes fail you. Then it will be well for you to bear in mind the following remedies, which, though infrequently indicated, may prove themselves to be of inestimable value.

Oenothera biennis, the evening primrose, commonly seen in the fields and waste places, is an invaluable remedy in exhausting, watery diarrhoea. It does not act, as has been suggested, as an astringent, by its tannic acid, but is a genuine homoeopathic remedy, producing and curing diarrhoea. The evacuations are without effort, and are accompanied by nervous exhaustion, and even by incipient hydrocephaloid. Gnaphalium causes a watery, offensive morning diarrhoea, which recurs frequently during the day. The provers were children, and well have they portrayed a very common group of cholera infantum symptoms. They had rumbling in the bowels, colicky pains, and were, at the same time, cross and irritable. The urine was scanty, and the appetite and taste were lost. A writer in the Homceopath mentions having used this drug very successfully, and Dr. Hale refers to it in his Therapeutics.

Geranium maculatum is also a successful baby's remedy. Dr. Hale devotes eight pages to Geranium and other astringents, dividing their action according to his rule of primary and secondary symptoms, and deducing thence two propositions for use in practice. The provings, brief though they are, help us in the choice of the drug; constant desire to go to stool, with inability for some time to pass any faecal matter, then the bowels move without pain or effort; mouth dry; tip of the tongue burning. The Allopaths use Geranium as an astringent. Paullinia sorbilis has been suggested for diarrhoea, which is green and profuse, but odorless.

Opuntia comes to us recommended by so careful an observer—Dr. Burdick—that, although I have not used it, I do not hesitate to present it anew. Nausea in stomach and bowels; feels as if the bowels were settled down into the lower abdomen (confined in adults). In infants we may, perhaps, look to this drug when the lower part of the abdomen is the seat of disease, as this seems to be its characteristic seat of attack.

Niiphar luteum causes a yellow diarrhoea, worse in the morning, either painless or with colic. It has been employed for diarrhoea during typhoid, and indeed seems to cause nervous weakness. Whether it will be of service for infants remains to be seen. We should look to it when Gamboge, Chelidonium , etc., fail, and when exhaustion is a prominent attendant.

Kali bromatum has been given successfully several times in cholera infantum, when there were great prostration, cool surface and symptoms of hydrocephaloid. Compare Cinchona (incipient hydrocephaloid, following prolonged or oft-repeated diarrhceic discharge), Calcareaphos., Carboveg., Veratnim album, Camphor, etc.

Returning now to Ipecacuanha, we should note another effect of the drug which is just as characteristic as its action on the bowels, namely, its action on the mucous membrane of the respiratory tract. Thus it may be used in coryza. The nose feels as if stuffed up; there is often epistaxis, loss of smell, nausea and some catarrh of the bronchial mucous membrane.

You may compare here Allium cepa, which is an excellent remedy for simple nasal catarrh when the nasal secretion is watery and acrid and the lachrymation mild. There are rough raw feeling in the throat and cough provoked by tickling in the larynx. I may say in qualifying these symptoms of Allium, that although it quickly stops the nasal catarrh, it frequently seems to drive the trouble to the chest. Phosphorus appears to stop this action of Cepa.

Euphrasia is very similar to Cepa in nasal catarrh. Here, however, we have excoriating lachrymation and bland nasal discharge. Arsenicum album follows Ipecacuanha, in the catarrhs of fat, chubby children.

Affecting prominently, as Ipecacuanha does, the pneumogastric nerves, we should expect it to be useful in affections which involve these nerves, such as asthma, in which disease it is indicated when there is a sensation as of constriction of the chest, worse from the least motion. When the patient coughs you hear the rattling of mucus in the chest, yet none is expectorated. Especially will you find this kind of asthma calling for Ipecacuanha in stout persons of lax fibre, either adult or child, who are particularly sensitive to a warm moist atmosphere.

Very similar to Ipecacuanha in asthma is Arsenicum album, which often follows it well either in catarrhal or nervous asthma. Cuprum metallicum is useful in asthma when the spasmodic element predominates. The face gets blue; there is constriction of the throat; the patient almost goes into convulsions.

Another drug closely allied to Ipecacuanha is Lobelia inflata. This has, with the asthma, a weak sensation in the epigastrium, spreading Wp into the chest, nausea, profuse salivation and a feeling as of a lump in the stomach.

Ipecacuanha is one of the best remedies we have for capillary bronchitis in infants, especially if caused by the kind of weather I have described. There is a great accumulation of mucus in the chest. The examining ear hears rales all through the chest, both anteriorly and posteriorly. The cough is spasmodic and usually attended with vomiting of phlegm. There may be fever and Ipecacuanha still be indicated. The child may have difficulty in breathing from the marked accumulation of mucus in the chest. In such cases, I have used the remedy in all potencies; that is to say, from the third to the twenty thousandth, and I have been well satisfied with its action. When Ipecacuanha is indicated, the stage for giving Aconite has passed, because exudation has begun. If you adhere to the principles of homoeopathy, you will not give Aconite and Ipecacuanha in alternation. After giving Ipecacuanha, you will notice that the mucus does not adhere so firmly to the walls of the bronchial tubes, but it becomes less tenacious and is raised more readily.

Let me warn you that there are two or three changes of symptoms which will call for concordant remedies. One of these changes calls for Antimonium tartaricum, and that is when the cough grows less and less frequent, the quantity of mucus in the chest not diminishing in amount. The infrequency of the cough is not a good symptom, although the mother will think so. The chest is so filled with mucus that the child cannot cough. He grows more and more drowsy. In giving Antimonium tartaricum in these cases, give it in frequent doses until the cough increases.

Another change calls for Phosphorus. This should be given when the inflammatory symptoms increase, the substance of the lungs becomes involved and pneumonia supervenes. Then Ipecacuanha ceases to be the remedy. Any one who practices in the colder parts of the country will find these catarrhs frequent, and with Aconite, Ipecacuanha, Antimonium tartaricum and Phosphorus, he can manage the great majority of his cases.

Still other remedies may be needed. In some cases Aiitimonium tartaricum, though apparently well indicated, fails to control the symptoms. Then we may have recourse to Sitlphur, which produces in the healthy a catarrh of the bronchial mucous membrane with loud rales all through the chest, particularly in the left lung. Especially is it indicated when there is atelectasis. I have used Sulphur with great success in just such cases.

Another remedy is Terebinthina , which I have used when the child was drowsy and the lungs seemed to be all clogged up. The urine is apt to be scanty and dark from the admixture of blood. Terebinthina must be given repeatedly.

Still another remedy is Lycopodium, which affects more markedly the right lung. Loud rales are heard all through the affected part. The expectoration is yellowish and thick.

We may be called upon to give Ipecacuanha frequently in whoopingcough, by virtue of the spasmodic character of the cough and the action of the drug on the pneumogastric nerve. You will find in addition to the symptoms already mentioned, that spasmodic convulsive symptoms are present. During the cough the child stiffens and becomes rigid from tonic spasm of the extensor muscles; loses its breath and turns pale or blue in the face. Finally it relaxes and vomits phlegm, which of course relieves. While Ipecacuanha is of excellent service here, you are reminded of two other drugs which are similar. One of these is Cina, which I must ask you to remember as being something more than a mere worm remedy. This remedy is useful in whooping-cough with the same kind of rigidity that I have described for Ipecacuanha, but there is in addition a clucking sound in the oesophagus as the child goes out of the paroxysm. If in addition to this symptom you also have grinding of the teeth, Cina is certainly a

better remedy than Ipecacuanha.

Cuprum metallicum is the complement of Ipecacuanha in spasmodic affections and in whooping-cough. It is especially indicated in convulsions from worms and during the course of whooping-cough. Spasms of the flexors predominate.

In fevers we may use Ipecacuanha, especially in those of an intermittent type. It is one of the best drugs to give when your case is mixed up. It is particularly indicated when there is a short chill, followed by long fever with nausea and vomiting, especially after the abuse of Quinine.

Ipecacuanha is an excellent drug for hematuria, for haemorrhage from the kidneys when the trouble is attended with nausea, oppression of the chest, hard breathing, and cutting pains in the abdomen. In some cases those who work in Ipecacuanha are affected with a violent inflammation of the conjunctiva. Now this fact led Jousset to apply the drug in the treatment of ophthalmia, and he claims many cures with it in the intense conjunctivitis of scrofulous children. There are tearing pains in and about the eyes and copious lachrymation. Tears gush forth ever}' time the lids are separated. When, however, there is marked keratitis, he prefers Apis.

In closing let me give you the Ipecacuanha temperament. Studied as a homoeopathic remedy, you will find it indicated in patients who are full of desires they know not for what. The child cries and screams continually. The adult is irritable and morose, holding everything in contempt.

Bismuth seems to hinder the action of Ipecacuanha.

Opium increases its action on the bronchial mucous membrane. COFFFA ARABICUM.

Coffea is extensively used as a beverage. Its alkaloid, Caffeine, is identical chemically with several others, such as Theine, the active principle of tea, and is related chemically to the purin bodies, xanthin, uric acid, etc.

Caffeine lessens the amount of urea excreted in the urine. It is useful when there is an extra drain on the system, particularly after hard work in hot weather, at which time the system is doubly exhausted by the fatigue and the heat combined.

Then a cup of coffee is a very good thing. So, too, it may be used after loss of sleep, when fatigue is more marked than it is after labor. Other things being equal, coffee is not so useful for the young as for the old. A man in active business life or one who works hard all day, or an elderly man in whom waste is out of proportion to repair, finds great benefit from coffee. In fact, it is almost instinctive on the part of workmen to fall back on coffee as a beverage, because it gives them what their food will not, a certain amount of strength and an antidote to the wear and tear of labor.

The effects of Caffeine on the system bear a certain resemblance to Strychnia. It seems to excite reflex action, and, if persistently given, tetanus as well. It produces sudden starting from the slightest touch of the surface of the body (like Strychnia), and increased susceptibility to all external impressions. This increased '

' excito-motor "

action explains many of its symptoms. Violent emotions, whether of pleasure or of pain produce symptoms. Patients experience sudden joy, and they are at once sick from the excitement. They awaken at night without any desire whatever to return to sleep. Coffea also produces an ecstatic state of mind. Here it finds a concordant remedy in Cypripedium. Especially is the latter remedy indicated in children who awaken at night from sleep, and are unnaturally bright and playful, and evince no desire to go to sleep again. Such symptoms are often preliminary to some brain affection, which the timely use of Cypripedium may avert.

Apoplectic congestion may be cured by Coffea, particularly if an excited state of the mind has been the cause of the excessive fulness of the cerebral blood-vessels. So, too, an animated conversation in which the party interested becomes greatly warmed up and has cerebral congestion will call for Coffea. This remedy is of value, however, only in the beginning of these cases; then it is all-sufficient. But if the. trouble goes on to effusion (not inflammatory effusion, but effusion of serum by oozing through the distended capillaries), you must have recourse to Belladonna, Bryonia or some remedy more adapted to effu-

Irritable; holds everything in contempt. Full of desires, for what they know not.

Ipecac-root The chief action is on the ramifications of the pneumogastric nerve, producing spasmodic irritation in chest and stomach. Morphia habit. The principal feature of Ipecacuanha is its persistent nausea and vomiting, which form the chief guiding symptoms. Indicated after indigestible food, raisins, cakes, etc. Especially indicated in fat children and adults, who are feeble and catch cold in relaxing atmosphere; warm, moist weather. Spasmodic affections. Hæmorrhages bright-red and profuse.

Worse, periodically; from veal, moist warm wind, lying down.

Bones of skull feel crushed or bruised. Pain extends to teeth and root of tongue.

Blue rings around eyes. Periodical orbital neuralgia, with lachrymation, photophobia, and smarting eyelids.

Inflamed, red. Pain through eyeballs. Profuse lachrymation. Cornea dim. Eyes tire from near vision. State of vision constantly changing. Spasm of accommodation from irritable weakness of the ciliary muscle. Nausea from looking on moving objects.

Coryza, with stoppage of nose and nausea. Epistaxis.

Tongue usually clean. Mouth, moist; much saliva. Constant nausea and vomiting, with pale, twitching of face. Vomits food, bile, blood, mucus. Stomach feels relaxed, as if hanging down. Hiccough.

Amebic dysentery with tenesmus; while straining pain so great that it nauseates; little thirst. Cutting, clutching; worse, around the navel. Body rigid; stretched out stiff. Stools.––Pitch-like green as grass, like frothy molasses, with griping at navel. Dysenteric, slimy.

Uterine hæmorrhage, profuse, bright, gushing, with nausea. Vomiting during pregnancy. Pain from navel to uterus. Menses too early and too profuse.

Dyspnœa; constant constriction in chest. Asthma. Yearly attacks of difficult shortness of breathing. Continued sneezing; coryza; wheezing cough. Cough incessant and violent, with every breath. Chest seems full of phlegm, but does not yield to coughing. Bubbling rales. Suffocative cough; child becomes stiff, and blue in the face. Whooping-cough, with nosebleed, and from mouth. Bleeding from lungs, with nausea; feeling of constriction; rattling cough. Croup. Hæmoptysis from slightest exertion (Millef). Hoarseness, especially at end of a cold. Complete aphonia.

Body stretched stiff, followed by spasmodic jerking of arms towards each other.

Pale, lax. Blue around eyes. Miliary rash.

With eyes half open. Shocks in all limbs on going to sleep (Ign).

Intermittent fever, irregular cases, after Quinine. Slightest chill with

much heat, nausea, vomiting, and dyspnœa. Relapses from improper diet.

Compare: Emetine-principal alkaloid of Ipecac (A powerful amebicide, but is not a bactericide. Specific for amæbiasis; of remarkable value in treatment of amæbic dysentery; also as a remedy in pyorrhea, 1/2 gr daily for three days, then less. Emetin, 1/2 gr hypodermically, in Psoriasis. Emetin hydroch. 2x, diarrhœa with colicky, abdominal pains and nausea. Emetin for endamoebic dysentery. In physiological doses must be carefully watched. May produce hepatization of lungs, rapid heart action, tendency for the head to fall forward and lobar pneumonia. In hæmatemesis and other hæmorrhages, compare: Gelatin which has a marked effect on the coagulability of the blood. Hypodermically; or if by mouth, a 10 per cent jelly, about 4 oz, three times a day) Arsenic; Cham; Puls; Tart em; Squill. Convolvulus (colic and diarrhœa). Typha latifolia-Cat-tail flag (dysentery, diarrhœa) and summer complaint. Euphorbia hypericifolia––Garden Spurge––(Very similar to Ipecac. Irritation of the respiratory and gastro-intestinal tracts and female organs). Lippia mexicana–– (Persistent dry, hard, bronchial cough––asthma and chronic bronchitis). In Asthma, compare: Blatta orientalis. Antidotes: Arsenic; China; Tabac. Complementary: Cuprum; Arn.

Third to 200th potency.

Ipeca

Ipecac. has a wide sphere of action among acute sickness. Most of its acute complaints commence with nausea, vomiting.

The febrile conditions commence with pain in the back between the shoulders, extending down the back, as if it would break, with or without rigors, much fever, vomiting of bile and seldom any thirst. This is the general aspect of the beginning of an Ipecac. fever or gastric. trouble or chill in intermittents or bilious attacks.

The stomach is disordered. There is a sense of fullness in the stomach, cutting pains in the stomach and below the stomach, going from left to right. The cutting pain in colic goes from left to right. The patient is unable to stir or breathe until that pain passes off. It holds him transfixed in one position, coming like the stabbing of a knife in the region of the stomach, or above the navel, going from left to right, and is attended with prostration and nausea.

Nausea: All the complaints in Ipecac. are attended more or less with nausea; every little pain and distress is attended with nausea. The sufferings seem to centre about the stomach, bringing on nausea.

There is continuous nausea, and gagging. The cough causes nausea and vomiting. It is a dry, hacking, teasing, suffocative cough, accompanied by nausea and vomiting. He coughs until his face grows red, and then there is choking and gagging. With every little gush of blood from any part of the body there is nausea, fainting and sinking.

Hence its value in uterine hemorrhages; bright, red blood with nausea; a little blood is attended with fainting or syncope, but the great overwhelming nausea runs through the complaints of this remedy. Though there is sometimes thirst, it is usually absent. When Ipecac. does its best work, there is thirstlessness.

With the Ipecac. fever, or with the chill, there is likely to be pain in the back of the head, a bruised pain through the head and back of the neck and sometimes down the back, and drawing in the muscles of the back of the neck. A congestive fullness in the head, a crushed feeling in the head and back of the head; the whole head aches and is full of pain.

Ipecac. is sometimes as restless as Arsenic., but the Ipecac. prostration comes by spells, whereas the Arsenic prostration is continuous. You will see Ipecac. patients tossing over the bed as much as they do when they need Rhus, turning and tossing, and moving the hands and feet, with restlessness.

This is especially the case when the spine is somewhat involved. Ipecac. has symptoms that look like tetanus it has opisthotonos, and it has been a useful remedy in cerebro-spinal meningitis with vomiting of bile, with pain in the back of the head and neck, and drawing of the muscles of the back, retracting the head.

Stomach: When cerebro-spinal meningitis has gone on until the patient is emaciated, when remedies have seemed but to palliate momentarily, and the whole body is inclined backwards, and there is vomiting of everything, even the simplest article taken into the stomach, the tongue is red and raw, and there is constant nausea and vomiting of bile, Ipecac. will cure. Ipecac. cures inveterate cases of gastritis when even a drop of water will not stay down; everything put in the stomach is vomited, continuous gagging, sharp pain in the stomach, pain in the back, below the shoulder blades, as if it would break, vomiting of bile, continuous nausea and great prostration. Irritable stomach. It also cures when the abdomen is distended, and sensitive, a tympanitic state, when there is vomiting of bile.

Ipecac. has proved a useful remedy in epidemic dysentery, when the patient is compelled to sit almost constantly upon the stool and passes a little slime, or a little bright red blood; inflammation of the lower portion of the bowel, the rectum and the colon. The tenesmus is awful, burning, and continuous urging with the passage of only a little mucus, and blood. With this there is constant nausea; while straining at stool, the pain is so great that nausea comes on, and he vomits bile. At times, whole families are down with it. It runs through a whole valley and may be epidemic, but it commonly relates to endemics.

In infants, it is indicated when a cholera-like diarrhoea has been present and it ends in a dysenteric state, with continued tenesmus, and the expulsion of a little bloody mucus, the child vomiting everything it takes into the stomach; nausea, vomiting, prostration and great pallor. It is also useful in such conditions when the stool is more or less copious, and is green, and the child passes, frequently, copious quantities of green slime. Much crying when at stool, much straining, with passages of green slime, vomiting of green slime, and vomiting of green curds; milk turns green and is vomited.

Chest: The chest complaints of Ipecac. are interesting. Ipecac. is especially the infant's friend and is commonly indicated in the bronchitis of infancy. The usual bad cold that ends in chest trouble in infants is a bronchitis. It is very seldom that an infant gets a true pneumonia, it is generally a bronchitis with coarse rattling. The child coughs, gags and suffocates, and there is coarse rattling which can be heard throughout the room, and the trouble has come on pretty rapidly. The child is pale, looks dreadfully sick, and sometimes looks very anxious. The nose is drawn in as if dangerously ill, and the breathing is such as appears in a dangerous case. Ipecac. will sometimes modify this into a very simple case, break up the cold, and cure the child.

In the old books, the pneumonia of infancy had a distinct and separate description, and the typical symptoms were those of Ipecac. You will see a great similarity of symptoms when you study Ipecac. and Ant. tart. together in chest troubles. If you have been studying them together, you will say, "How do you distinguish them; they both have rattling cough and breathing, and both have the vomiting?"

Well, the Ipecac. symptoms correspond to the stage of irritation, while the Tartar emetic symptoms appear in the stage of relaxation. That is, the Ipecac. symptoms come on hurriedly, come on as the acute symptoms, whereas the Tartar emetic complaints come on slowly. The latter is seldom suited to symptoms that arise within twenty-four hours, or at least the symptoms of Tartar emetic that arise in twentyfour hours are not of this class.

This group comes on many days later, comes on at the close of a bronchitis when there is threatened paralysis of the lungs; not in the state of irritation, not the dyspnoea from irritation, not the suffocation of that sort, but the suffocation from exudation, and from threatened paralysis of the lungs.

When the lungs are too weak to expel the mucus the coarse rattling comes on. Then there is the great exhaustion, deathly pallor of the face and sooty nostrils.

We see now that these two remedies do not look alike. If we observe the pace of the two remedies, we see that the complaints differ. It is not so much. that they belong to stages, although they do, but rather that Ipecac. brings on its symptoms rapidly and effects a crisis speedily, and that Ant. tart. brings on its symptoms slowly and effects a crisis after many days.

You can readily see the value of Ipecac. in whooping cough, for it has the paroxysmal character, the red face, and vomiting and gagging with the cough. The red face, thirstlessness, violent whooping, with convulsions, with gagging and vomiting of all that he eats are the symptoms that you will generally find.

Haemorrhages: I have hinted at the haemorrhages, and these open out a great field for Ipecac. I could not practice medicine without ipecac., because of its importance in hemorrhages. When I say haemorrhages, I do not mean those from cut arteries, I do not mean haemorrhages where surgery must come in; I mean such as uterine haemorrhages, haemorrhages from the kidneys, from the bowels, from the stomach, from the lungs. You must know your remedies in haemorrhages; if you do not, you will be forced to use mechanical means; but the homeopathist who is well instructed is able to do without them. In the severest form of uterine hemorrhages, the homeopathic physician is able to do without mechanical means, except when mechanical means are causing the haemorrhage.

This does not relate to hourglass contractions, it does not relate to conditions when the after birth is retained, or when the uterus has a foreign substance in it, because under such circumstances manipulation is necessary. A distinction must be made. But when we have simply the pure dynamic element to consider, simply and purely a relaxed surface that is bleeding, the remedy is the only thing that will do the work properly. When the uterus is continuously oozing, but every little while the flow increases to a gush, and with every little gush of bright red blood the woman thinks she is going to faint, or there is gasping, and the quantity of the flow is not sufficient to account for such prostration, nausea, syncope, pallor, Ipecac. is the remedy.

When with the gushing of bright red blood there is an overwhelming fear of death, Aconite. If your patient while going through the confinement has had a hot head, an uncontrollable thirst for ice cold water, and after the confinement, everything has gone on in an orderly way, and the placenta has been delivered, and although you have no reason to expect such haemorrhage it comes on, Phosphorus will nearly always be the remedy.

In those withered women, lean and slender, who are always suffering from the heat, who want the covers off and want to be cool, who have had a tendency to ooze blood from the uterus, and now have a haemorrhage that is alarming either with clots, or only an oozing of dark liquid blood, you can hardly do without Secale. A single dose of any one of these medicines on the tongue will check a haemorrhage more quickly than large doses of strong medicine.

The haemorrhage will be checked so speedily that in your earlier experiences you will be surprised. You will wonder if it is not possible that it stopped itself. In copious menstruation Ipecac. is often indicated When the woman has taken cold, or has a shock. In cases where she is not especially subject to copious uterine flow at the menstrual period, she is naturally alarmed, for it is something she has never bad before, and the flow is likely to continue for many days, attended with this weakness. All her power seems to go with a little gush of blood. Ipecac. will cure and end the menstrual flow normally. A fortunate thing in nature is the tendency to check haemorrhage, which is always good.

There are a large number of medicines that control haemorrhage, and these you must keep at your finger's ends. They belong to emergencies. You must know the remedies that correspond to violent symptoms and violent attacks. Ipecac. is full of hemorrhage. Vomiting of great clots of blood, continuous vomiting of blood in connection with ulceration. In persons who are subject to violent attacks of bleeding, who bleed easily, who have a haemorrhagic tendency, Ipecac. will control temporarily the haemorrhage when the symptoms agree.

Urines: Severe pain in the back in the region of the kidneys, shooting pains, frequent urging to urinate, and the urine contains blood and little clots of blood. The urine is extremely red with blood, which settles to the bottom of the vessel, and lines the whole commode with a layer of blood the thickness of a knife blade. Every pint of urine that it contains will have that coating of blood in the vessel; every attack of pain in the kidney is attended with that condition of the urine. Ipecacuanha will stop that bleeding. It is true that when patients have bled until they have become anaemic, and are subject to dropsy, Ipecac. ceases to be the remedy; its natural follower then is China, which will bring the patient in a position to need an antipsoric remedy.

Colds: Then there are the "colds."

Simple, common coryzas among the children. When a cold settles in the nose, and the nose is stuffed up at night or when the adult has a coryza, with much stuffing up of the nose, blowing of mucus and blood from the nose, much sneezing, and the cold goes further down and is followed by hoarseness, extending into the trachea with rawness, and finally into the bronchial tubes with suffocation and settling in the chest, think of ipecac.

The Ipecac. colds often begin in the nose and spread very rapidly into the chest. With these colds in the nose there is copious bleeding of bright red blood. Every time he takes cold in the nose he has copious bleeding; a tendency to nosebleed with the colds. The inflammation that comes upon the mucous membrane in Ipecac. is violent.

The irritation comes on suddenly, and the mucous membrane inflames so rapidly that the parts become purple, turgescent, and bleeding seems to be the only natural relief. Stoppage of the nose and loss of smell; the nose becomes so stuffed up that he cannot breathe through it. With the head symptoms, with the colds, with the whooping cough, with the chill, and with many of the inflammatory complaints, the face becomes flushed, bright red, or bluish red, and the lips blue; with the chill the lips and the finger nails are blue. The chill is violent, sometimes congestive in character and often a rigor. The whole frame shakes, and the teeth chatter. There are old incurable cases of asthma that are palliated by Ipecac. and carry around a bottle of it from which they say they get much relief. It is useful in cases of humid asthma, in cases of asthmatic bronchitis, when they suffer from the damp weather and from sudden weather changes; every little cold rouses up this bronchial attack, and he suffocates and gags when he coughs, or spits up a little blood.

He has to sit up nights to breathe, and the attacks are common and frequent. These patients say they get relief front Ipecac., and it is not surprising that Ipecac. relieves that state of asthmatic breathing, because it has such symptoms. Some of these cases are incurable, they are people advanced in life.

This remedy, more wisely administered, will give more relief. A powder of Ipecac. will break up the attack, so that the patient is comfortable, and then will go on in an ordinary sort of asthmatic way, until catching another cold. The cough is rattling and asthmatic.

Convulsions: As a convulsive medicine Ipecac. is not well enough known.

Convulsions in pregnancy. Convulsions in whooping cough; frightful spasms, affecting the whole of the left side, followed by paralysis; clonic and tonic spasms of children and hysterical women. Tetanus, rigidity of the body, with flushed redness of the face.

These are strong features of Ipecac., and they have not been sufficiently dwelt upon, and the remedy is not sufficiently known as having these states so prominently. Medicines like Belladonna are more frequently spoken of in the books and in treatises of spasms, yet Ipecac. is just as important a remedy to be studied in relation to spasms, and its action upon the spine.

Skin: In suppressed eruptions, the symptoms will very commonly point to Ipecac.

When the eruption does not come out, or an eruption has been driven back by cold, sometimes acute manifestations of stomach and bowels follow and colds settle in the chest from suppressed eruptions, Ipecac. will also cure erysipelas, when there is the vomiting, the chill, the pain in the back, the thirstlessness and the overwhelming nausea.Ipecac. is often sufficient for the nausea and vomiting when the scarlet fever rash is slow to come out. Instead of the rash coming out as it should, Ipecac. symptoms come on in the stomach with nausea and vomiting. Ipecac. will check the nausea and vomiting, will bring out the eruption, and the disease will run a milder course.