Pulsatilla

digestive or menstrual disorders. SUPPRESSIONS; otorrhœa, menses, lochia, milk, etc. Metastases. Alternations. Phlegmasia. Venosity. Hæmorrhage; passive; vicarious. Anæmia. PROFUSE, BLAND, THICK, YELLOW-GREEN DISCHARGES; bitter mucus. Jerking, tearing or ulcerative pain. Numbness; part lain on; hands, feet, etc. Pale, chilly blondes. .................... MILD, TIMID, EMOTIONAL. WEEPY. Discouraged. Whining. Easily offended. Craves sympathy. Can't lie with head low. Headache start in vertex. Occipital ache, < coughing. Profuse sweat on scalp. Eyes; fill with tears (acrid) or seem covered; < wind; sticky lids; colds affect the; ophthalmia, gonorrhœal. Blepharitis. Styes. Blind attacks; < menses. Nightly earache. Foul discharge or bad odor before nose. Coryza; stopped on lying or in room. Anosmia. Pale face. Peeling cracked lips. Licks lips. Crack in center of lower lip. Bad breath. Drawing toothache, > cold. Taste bad; in A.M.; bloody; greasy. Slimy mouth or dry, without thirst. Tongue feels scalded. Alternate sides of throat or neck. Food leaves an after-taste or lodges in throat. Averse to water or fats. Craves acids or what disagrees. Sudden loathing, < eating. Heart-burn. Nausea. Epigastrium; cutting; pulsation. HEAVY OR DERANGED STOMACH. Abdomen; as of a heavy stone; aching; numb; pains into groins. Stools; changeable; green mucus, < after midnight; bilious. Piles, < lying. Urination; involuntary on lying; followed by blood. Heavy pressure on or cramp in bladder. Sensation as of a stone rolling in bladder. Nocturnal enuresis. Burning down l. spermatic cord. Enlarged prostate. Orchitis; gonorrhœal. Bloody emissions. Feels like menstruating. MENSES DARK; LATE, at puberty; SCANTY, < bathing; irregular; vicarious; absent. Dysmenorrhœa. Weak labor pains. Bearing down, < lying. After pains. Retained placenta. Leucorrhœa; milky; acrid. AIR HUNGER; < lying on l. side; as if from abdomen; if heated. Loose morning, then dry evening cough; from tickling in epigastrium; must sit up. Expectoration thick; purulent (Cetrar.), slimy, sweet, salt, etc. Asthma from suppressions. Cough; dry hacking; expectorates bitter or salty as it loosens up. Chest oppressed; as by a load. Sore stitch beneath clavicles. Palpitation. Mammæ; milk in virgin; sore, aching lump (r); scanty milk. Swelled joints; backs of feet. Numb elbows. Lower limbs; pains down, alternate sides; heavy legs. Sticking in tibia, < lying, > cool air and motion. Acute periostitis. Cold sweat on legs. Foul foot-sweat. Swelled glands. Veins full; varicose; painful. Ulcers, with hard, glistening areolæ; varicose. Skin itches on being heated. Measles. Day sleepiness. Lies with hands over head. Disturbed dreams. Awakes confused or tired. Chilly, yet averse to heat; IN A WARM ROOM; with the pain; on lying down at night. One hand cold. Partial sweat.

WARMTH: AIR. ROOM. Clothes. BED. Getting feet wet. SUPPRESSIONS. EVENING. REST. BEGINNING MOTION. LYING; one side (L). EATING: RICH FOOD. Long after. FATS. Ices. Eggs. PUBERTY. PREGNANCY. Before menses. Iron. Quinine.

COLD; FRESH, OPEN AIR. Uncovering. ERECT POSTURE. Gentle motion. Continued motion. After a good cry. CHANGEFUL. SHIFTING SYMPTOMS; rising to a certain pitch, then suddenly ceasing; going to part lain on; unilateral. THIRSTLESS, SHORT OF BREATH AND CHILLY; with

MIND. VEINS. MUCOUS MEMBRANES: TONGUE. STOMACH. BOWELS. FEMALE AND GENITO- URINARY ORGANS. Respiration. One side. Right heart.

Complementary: Ars. Kali-bi. Sep. Sil. Zin. Related: Ap. Cimi. Grap. Ham. Kali-bi. Nat-s.

Pulsatilla

Anemone. Ranunculacece.

Adapted to persons of indecisive, slow, phlegmatic temperament; sandy hair, blue eyes, pale face, easily moved to laughter or tears; affectionate, mild, gentle, timid, yielding disposition — the woman’s remedy.

Weeps easily: almost impossible to detail her ailments without weeping (weeps when thanked, Lyc.).

Especially, in diseases of women and children.

Women inclined to be fleshy, with scanty and protracted menstruation (Graph.).

The first serious impairment of health is referred to puberic age, have “never been well since” — ansemia,” chlorosis, bronchitis, phthisis.

Secretions from all mucous membranes are thick, bland and y ell ozvish- green (Kali s., Nat. s.).

Symptoms ever changing ; no two chills, no two stools, no two attacks alike; very well one hour, very miserable the next; apparently contradictory (Ign.).

Pains : drawing, tearing, erratic, rapidly shifting from one part to another (Kali hi.. Lac c., Mang. a.) ; are accompanied with constant chilliness; the more severe the pain, the more severe the chill ; appear suddenly, leave gradually, or tension much increases until very acute and then “lets up with a snap;” on first motion (Rhus).

Thirstlessness with nearly all complaints ; gastric difficulties from eating rich food, cake, pastry, especially after pork or sausage; the sight or even the thought of pork causes disgust; “bad taste” in the morning.

Great dryness of mouth in the morning, without thirst (Nux m. — mouth moist, intense thirst, Mer.).

Mumps ; metastasis to mammae or testicle.

“All-gone” sensation in stomach, in tea drinkers especially.

Diarrhoea : only, or usually at night; watery, greenish-yellow, very changeable; soon as they eat; from fruit, cold food or drinks, ice-cream (Ars., Bry. ; eating pears, Ver., China; onions. Thuja; oysters, Brom., Lyc. ; milk. Cal., Nat. c., Nic., Sul.; drinking impure water. Camp., Zing.).

Derangements at puberty; menses, suppressed from getting the feet wet; too late, scanty, slimy, painful, irregular, intermitting flozv, with evening chilliness; with intense pain and great restlessness and tossing about (Mag. p.) ; flozus more during day (on lying down, Kreos. ). Delayed first menstruation.

Sleep : wide awake in the evening, does not want to go to bed; first sleep restless, sound asleep when it is time to get up; awakes languid, unrefreshed (rev. of, Nux).

Styes : especially on upper lid ; from eating fat, greasy, rich food or pork (compare, Lyc., Staph.).

Threatened abortion ; flow ceases and then returns with increased force; pains spasmodic, excite suffocation and fainting; must have fresh air.

Toothache : relieved by holding cold water in the mouth (Bry., Coff.) ; worse from warm things and heat of room.

Unable to breathe well, or is chilly in warm room.

Nervousness, intensely felt about the ankles.

{Continued) .

Sulph. ac. ; Kali m. its chemical analogue.

Silicea is the chronic of Pulsatilla in nearly all ailments.

Follows, and is followed by, Kali m.

One of the best remedies with which to begin the treatment of a chronic case (Cal., Sulph.).

Patients, anaemic or chlorotic, who have taken much iron, quinine and tonics, even years before.

Ailments : from abuse of chamomile, quinine, mercury, tea-drinking, sulphur.

Follows well : after. Kali bi., Lyc., Sep., SiL, Sulph.,

Aggravation, — In a warm close room; evening, at twilight; on beginning to move; lying on the left, or on the painless side; very rich, fat, indigestible food; pressure on the well side if it be made toward the diseased side; warm applications; heat (Kali m.).

Amelioration. — In the open air; lying on painful side (Bry.) ; cold air or cool room; eating or drinking cold things; cold applications (Kali m.).

Lecture XXXIV — Pulsatilla

Pulsatilla. { f Blood-vessels.

Mucous membranes.

Synovial membranes.

^ Organs.

Compare with Bryonia, Nux vomica, Antimonium crudum, Ipecac, Sulphur, Sulphuric acid, Arsenicum, Colchicum, Kali bichromicuvi , Caulophyllum , Ignatia, Actea racemosa, Helonias, Hamamelis, Sepia. To-day we shall study Pulsatilla. The species which we shall consider is the Pulsatilla of Hahnemann, the Pulsatilla praiensis, and not the American plant, the Pulsatilla Nuttalliana. There is some little difference in the action of the two drugs. The " pratensis" has been better proved. The concordant remedies of this drug are almost without number. The reason for this is that it is a well-proved remedy, and one, too, that is often indicated. Its complementary remedies are Sulphuric acid and Lycopodium.

Its antidotes are Chaviomilla, Coffea, Ignatia and Nux vomica. The relation of Pulsatilla or Sulphuric acid calls for particular notice. The latter remedy follows the former in gastric troubles. Pulsatilla is also antidotal to Sulphuric acid. When this acid has been used for the cure of the appetite for liquor, Pulsatilla has been proposed as the remedy best suited for the diarrhoea which ensues.

Pulsatilla pratensis is a pretty little flower belonging to the anemone. It has been called the wind-flower, and its name is in keeping with its symptoms, as they are as fickle as the wind. Changeableness of the symptoms is characteristic of the drug. This is especially marked in the haemorrhages, which apparently stop and in a few hours return. It is also true of the diarrhoea, the stools continually changing their appearance—at one time being green, at another mixed with yellow, and at still another slimy.

The mental symptoms are of the same fickle nature, the patient now being irritable, then tearful, and again mild and pleasant. These are illustrations of the changeableness that I have described. Pulsatilla seems to be especially adapted to the female organism, although it affects men as well as women. It is one of those remedies which we are apt to select by the predominance of the mental symptoms. It is especially indicated in patients of a mild, tearful disposition, having a rather slow, phlegmatic temperament. They are never irascible, although at times peevish. Thus, in the case of a child with some gastric ailment, Pulsatilla may be used when it is peevish, pale, chilly, and satisfied with nothing. This is not the Nux vomica condition, nor is it like Chamomilla, both of which remedies have decidedly more violence with their anger.

The Pulsatilla woman is tearful and easily discouraged. Sometimes she is full of anxiety, with forebodings of some impending disaster. This anxiety comes from the epigastrium and is very likely to be associated with indigestion. It is often accompanied by chattering of the teeth, palpitation of the heart and flushes of heat. These are the main mental symptoms of Pulsatilla. They are present, more or less, in every disease in which it is the remedy.

In these mental symptoms you should compare Sepia, which, you will recall, has a similar mental state; but it differs from Pulsatilla in the presence of irritability and anger. There is also indifference to her household affairs, to which she was formerly attentive. Natrum muriaticum also has tearful disposition similar to that of Pulsatilla, but consolation under Natrum mur. aggravates, while under Pulsatilla the patient seeks consolation.

Stannum metallicu?n likewise has this tearful disposition. The patient is very much discouraged, or is tearful over his chest symptoms. He fears that he will go into a decline.

The Ignatia patient is sad, but she hides her grief from others. Pulsatilla is especially suitable for chlorotic or anaemic women, when they complain constantly of a feeling of dulness, but in spite of this find relief for many of their symptoms in the open air. They cannot tolerate a close room. The pains from which they suffer seem to be accompanied by chilliness. This chilliness is more marked the more decided the pains are. The mental symptoms already mentioned are present. Especially is Pulsatilla the remedy when chlorosis has been complicated by the abuse of iron and quinine. Chlorotic patients, coming to you from allopathic hands after iron and quinine have failed to relieve, thus showing you that these remedies are not suitable to the case, will find their first, if not their only remedy, in Pulsatilla. You will frequently find this hint of service to you in practice, not only in chlorosis, but in other affections as well, when they arise, not so much from local disease, as from a general defective state of nutrition; the whole system is worn out; ever}' tissue is relaxed. The woman suffers from mal-position of the uterus. The menses are late and scant}', dark, clotted or changeable in character. Pulsatilla does not always cure after the abuse of iron, but it stands in the same relation to this substance that Nux vomica does to the abuse of drastic purgatives, and Camphor to cantharides.

To understand how these phenomena of Pulsatilla are caused — whether in women, where they are most frequently met with, or more exceptionally in men—you must remember that the drug acts upon the vascular system, especially upon the right heart, and upon the veins and capillaries. Thus we find that whatever weakens the venous portion of the circulation, whatever retards the return of blood to the heart, must of course provoke just the class of symptoms for which Pulsatilla may be indicated. We know, for instance, that a warm, close room will provoke these symptoms. If a person sits in a close room or in one where the temperature is too high, the veins will become tortuous and there will be some oppression about the chest and retardation of the heart's action. When these symptoms occur in disease they suggest Pulsatilla. It acts on the right heart more than on the left, consequently, despite the chilliness which arises from the anaemia, the open air acts as a stimulus to the venous circulation, and this improves the symptoms depending upon the sluggish flow of blood. You will find many symptoms throughout the entire body calling for Pulsatilla when there is this disturbance in the venous circulation.

In the chest there is a feeling of soreness referred to either the right or the left sub-clavicular region, or to the apex of one or the other lung. This soreness is felt when the patient lies on the affected side or presses against the chest. It seems to involve the muscular structures about the shoulder and even down the arm of the affected side. This symptom indicates venous congestion, or, at least, sluggish circulation through the upper part of the lung. It has been a valuable symptom to me and to many physicians in the incipiency of tuberculosis, especially in women of the Pulsatilla temperament. Along with this soreness in the lung there may be some cough with expectoration. Although there may be no symptoms indicating the positive existence of tuberculous infiltration we will have other symptoms indicating the onset of the disease. Pulsatilla has several times relieved these cases. Then, too, we have Pulsatilla indicated in varicose veins, whether occurring on the limbs or about the testicle (varicocele). The affected parts are bluish and annoy the patient by the soreness and stinging pains in them.

The epistaxis of Pulsatilla is of a passive character. The flow comes steadily, but it is not .bright red and does not come in gushes as it does in epistaxis dependent upon arterial lesions. It often occurs vicariously, taking the place of the menses. The same is true of the blood-spitting or haemoptysis, which is either associated with this soreness or passive congestion of the chest or is dependent upon suppressed menstruation.

Pulsatilla has an important analogue, namely, Hamamelis, in these venous symptoms. Before Hamamelis was proved Pulsatilla was the only remedy we could depend upon in the class of symptoms enumerated. Hamamelis is the preferable drug in varicose veins unless constitutional symptoms call for Pulsatilla, especially in the case of varicocele. Varicocele has been cured by Ha?namelis applied externally and taken internally. The great characteristic of this drug, and that which makes its choice certain, is soreness of the affected part. It is a soreness which is not exactly the bruised feeling of Arnica; it is not the sensitive soreness of Lachesis; nor the stinging soreness of Apis; but it is that sore feeling which belongs to venous congestion. You may apply Hamamelis successfully in any condition in which that is present. I have often made use of the drug in pregnancy, when varicose veins appeared over the abdomen, and when the patient could not make any motion without experiencing a bruised sore feeling. Hamamelis is not the panacea which druggists would have us believe. It does not cure everything, sprains, etc., but it does cure the class of symptoms I have mentioned.

Another concordant remedy of Pulsatilla is Lilium tigrinum, which, like the former, affects the right heart', producing engorgement of the veins, relief in the open air, scanty menses, and taste of blood in the mouth. But it differs from Pulsatilla in the decided tendency to prolapsus uteri, with bearing down, relieved by supporting the abdomen, or by crossing the limbs; and in the mental state, which is one of irritability and restlessness with constant desire to hurry. Furthermore, when Lilium is indicated, a sharp pain, extending from the left nipple through the chest to the back, is apt to be present.

Another analogue is Sepia, which has many of the Pulsatilla symptoms. Sepia, also, is indicated in anaemia and chlorosis, and it also has the mild tearful temperament, but there is a difference in the mental symptoms. With Sepia there may be irritability or at times vehemence.

The Sepia patient has complete aversion to her usual household duties.

Let us now consider the action of Pulsatilla on mucous membranes. This is easily remembered. It produces a catarrhal inflammation of the mucous membrane, which ends in the production of bland yellow or yellowish-green mucus. You have here an indication which you may apply to any mucous membrane.

Conjunctivitis calls for Pulsatilla when the discharge is thick, yellow or yellowish-green, and bland; hence it is not indicated in the beginning of the disease, but later in its course, when the symptoms have matured. It is an invaluable remedy in ophthalmia after measles, in purulent ophthalmia, and in ophthalmia neonatorum (whether these troubles are of gonorrhceal origin or not), when the discharge is of the character just described. Its analogue here is Argentum nitricum, which has precisely the same symptoms in more marked degree, and is to be used after the failure of Pulsatilla. The latter in turn sometimes serves as an intercurrent to spur on the action of Argentum nitricum.

Mercurius corrosivus is suitable in cases which, despite the use of Argentum nitricum, threaten to ulcerate and perforate the cornea. These are not by any means the only eye symptoms of Pulsatilla. Dr. George S. Norton, of New York, published in the Hahnemannian Monthly, some years ago, a paper on the use of this remedy in diseases of the eye, which covered some six or eight pages. In addition to the conjunctival inflammation just noticed, Pulsatilla causes obscuration of vision, with vertigo and nausea, diplopia, starry apparitions, circles of fire, etc. (these generally being reflex symptoms); pustules on the cornea, with very little dread of light, but with lachrymation, worse in the open air; pressing, stinging pains in the eye; swollen lids; styes, relieved when in the open air; margins of the lids inflamed and swollen, but not excoriated.

In ophthalmia, with very little photophobia, it resembles Graphites, but has not the cracks along the lid-edges.

Pulsatilla is also an excellent remedy in small central corneal ulcers, with no vascular supply, especially when occurring in scrofulous subjects. It may still further be used in lachrymation from disease of the lachrymal duct when the symptoms just enumerated are present, and for lachrymation worse in the wind.

Pulsatilla also affects the nasal mucous membrane, developing here symptoms which indicate it in the advanced stages of a cold. It should not be given in the beginning of a cold unless the temperament and other symptoms decide, because sneezing and serous excoriating discharge are not characteristic Pulsatilla symptoms. But when you find a nasal catarrh "ripened," that is, when the nasal discharge is thick, muco-purulent, yellowish or yellowish-green, and not in the least excoriating, you have a perfect picture of Pulsatilla. In chronic nasal catarrh you may give Pulsatilla if the discharge is of this character. You must give the drug frequently and persistently, in order to cure. In addition to the symptoms already enumerated, there is still another symptom, namely, loss of taste and smell. There is a remedy known as Cyclamen, which is very similar to Pulsatilla in its symptomatology. It seems to be suited to nasal catarrh when there are loss of taste and smell, and this thick discharge just like that of Pulsatilla; but it has, in addition, spasmodic sneezing and aversion to the open air.

Pentkorum sedoides is useful in the incipiency of coryza when there is rawness in the nose and throat. The patient complains of a constant wet feeling in the nose, but without coryza. I^ater, there is a formation of thick purulent discharge, just as in Pulsatilla. Spigelia is one of our best remedies for catarrh of the posterior nares. The symptoms indicating it are profuse discharge of mucus through the posterior nares; nasal mucus passes off only through the posterior nares. This drug has accomplished some good cures in the hands of Dr. Aug. Korndoerfer, who also recommends Theridion for this affection.

Hydrastis is also suited to post-nasal catarrh. The discharge is of a thin watery character, and is attended with a great deal of burning and rawness, together with a sensation as of a hair in the nostrils. Pulsatilla is an invaluable remedy in affections of the ears. In otitis externa you may use it when the external ear is hot, red, and swollen, and there are darting, tearing, pulsating pains, which are worse at night.

In otitis media also it is useful when there is a profuse thick yellow or yellowish-green discharge from the ear.

Pulsatilla is one of our leading remedies in catarrhal otitis. There is deafness, with a feeling as if the ears were stopped up, with rushing noises in the ears, isochronous with the pulse. Silicea is the nearest remedy to Pulsatilla in catarrhal otorrhcea.

Belladonna and Mercurius have a deeper action than Pulsatilla, acting on the cellular tissues.

Chamomilla is similar to Pulsatilla in the ear symptoms, but the pains are more violent, and are attended with red cheeks; the patient cannot bear pain.

Plantago major is to be thought of when earache is associated with toothache.

Tellurium causes catarrh of the middle ear, which may penetrate into the cells of the mastoid process and establish an abscess there, or may even involve the internal ear or the brain. Pus forms in the middle ear, and finally, perforating the membrana tympani, escapes externally. The resultant discharge is thin and acrid, causing blisters wherever it touches, and smells like fish-brine.

In catarrh of the throat you will find Pulsatilla sometimes, though not frequently, the remedy. It would here be indicated by the appearance of -the parts. There are a marked redness of the tonsils and a varicose condition of the blood-vessels of the parts, and the fauces have a dark red or purplish hue. There are also stinging pains in the throat (here reminding you of Apis), worse usually from swallowing saliva or after eating food.

Leaving the pharynx we next come to the stomach, where we find Pulsatilla indicated in catarrhal conditions. The tongue is coated with a thick rough white fur. The mouth feels dry, and yet there is not much thirst, thirstlessness being a characteristic of the remedy. There are also nausea, and sometimes vomiting, the vomited matters consisting either of food or mucus, and also of bile. The food vomited may have been that eaten a long time before, thus showing the weak digestion of the remedy. There is a feeling of fulness and heaviness in the stomach after eating, sometimes associated with a feeling of rawness in the stomach as from ulceration. The latter is merely a subjective symptom and is a common sensation in Pulsatilla. Usually there is diarrhoea, with slimy or watery stools, worse after midnight. Attending these gastric symptoms is heartburn and sometimes, though rarely, water-brash. When water-brash calls for Pulsatilla there is a putrid taste in the mouth in the morning, better after drinking. The patient craves lemonade. He may complain that his mouth is dry, yet it seems to contain plenty of mucus. Other symptoms experienced are: feeling of weight in the epigastrium an hour after eating, relieved by eating again; feeling in the oesophagus as if food were lying there (also China, Abies)-, throbbing in the epigastrium; much flatulence which moves about, causing pinching pains and rumbling, worse on awaking or just after supper. Now these are the symptoms calling for this remedy in gastric catarrh. What are the exciting causes ? First of all and most important, Pulsatilla is called for when the trouble has arisen after partaking of fatty food or of pastry. It is also indicated in gastric catarrh arising from a mixed diet, as turkey, vegetables, coffee, etc., especially if eaten at night; also after chilling the stomach with ice-cream or ice-water, especially if the stomach is warm. In still other cases it may be indicated after getting wet, especially after getting the feet wet when suppression of the menses ensues. Let us now differentiate this remedy from the others commonly used in these dyspeptic symptoms. The most important remedies besides Pulsatilla, having aggravation from eating fatty foods, are Ipecac, Thuja and Carbo veg. Arsenicum and Carbo veg. have aggravation from eating ice-cream, and Nux vomica and Ipecac, from partaking of a mixed diet, or aggravation from eating at night; in this condition^ you may think also of Cinchona. In desire for lemonade, compare Cyclamen, Sabina and Belladonna; nausea at the thought or smell of food, particularly if rich or fat, Sepia and Colchicum; in vomiting of food long after eating, Kreosote.

Bryonia produces a catarrh of the stomach with white coated tongue, putrid taste in the mouth and a feeling as of a heavy load in the stomach. It may also be indicated in gastric catarrh brought on by chilling the stomach, although it is more suitable when the trouble has been brought on by the heat of summer weather. Bryonia usually, however, has constipation as an accompanying symptom, or if it has diarrhoea, it has not this yellowish-green or watery stool. Instead of this, the stools are papescent and have a putrid odor like old cheese. Nux vomica resembles Pulsatilla. Both are serviceable in catarrh of the stomach arising from overeating or from a mixed diet. Especially is Nux indicated after indulgence in alcoholic drinks. Dryness of the mouth with little or no thirst and uncomfortable feeling about the stomach, are also found under Nux vomica. The bowels are constipated. Comparatively speaking, we may say that heartburn is more characteristic of Pulsatilla and water-brash more characteristic of Nux vomica. The mental symptoms of the two remedies differ widely, and they should be easy to distinguish on this account. Antimonhim crudum resembles Pulsatilla, but the tongue under this remedy is coated white as though it had been whitewashed. Vomiting predominates over the other symptoms. A slight quantity of food excites nausea and vomiting. It is an excellent remedy in children. Ipecacuanha is a first-class remedy in these gastric catarrhs caused by chilling the stomach with ice-water or by eating pastry, confectionery or other indigestible substances. Usually the tongue is clean. It seldom has the thick coating belonging to Pulsatilla or Antimonium crudum, and nausea predominates over every other symptom. Arsenicum is complementary to Pulsatilla when gastric catarrh arises from chilling the stomach with ice-cream or ice-water. Under Pulsatilla there is a sensation as of a stone in the epigastrium. You will find a similar symptom under Abies nigra, which has been successfully used in gastric troubles when the patient experiences a sensation as of a hard-boiled egg in the stomach after eating. You may use Pulsatilla in constipation occurring in pregnant women or following the abuse of Cinchona and its preparations. The stools are large, with much urging and backache, or they are insufficient and finally consist of nothing but yellow mucus. You may also use it for diarrhoea when the stools are of a greenish-yellow color or are very changeable. The trouble is usually caused by partaking of a mixed diet late the night before, and the symptoms are apt to be markedly worse after midnight.

Here you should compare Iris versicolor, which is one of the best remedies we have for cholera morbus, coming preferably at two or three o'clock in the morning with vomiting of food and sour, bilious matters, accompanied by purging. It differs from Veratrum album in the absence of coldness and symptoms of collapse.

In cystitis or catarrh of the bladder we find Pulsatilla indicated when there is frequent urging to urinate from pressure on the bladder as if the bladder were too full. There is pain in the urethra. The urine itself is often turbid from the admixture of mucus. Clinically, we have not found Pulsatilla a first-class remedy in cystitis, but we have found it almost always the remedy in cystic symptoms accompanying pregnancy. It yields to Cantharis, Equisetum and Dulcamara in cystitis.

Gonorrhoea calls for Pulsatilla when the discharge is thick, bland and yellow or yellowish-green. There are usually pains in the groins when this drug is indicated, and I have noticed, too, pains going across the hypogastrium from side to side, a symptom that has sometimes been produced by overdosing with Pulsatilla. After giving it a few times in these cases, the patient returns, complaining of this aching across the stomach. This symptom occurring thus, calls for the lengthening of the intervals between the doses, or else for its stoppage altogether.

In suppression of gonorrhoea, Pulsatilla is indicated if orchitis, or rather epididymitis, ensues. The testicle is retracted, enlarged, very sensitive to the touch and the skin of the scrotum is dark red. There are sharp dragging pains following the course of the spermatic cord. Unless some other symptoms contra-indicate it, Pulsatilla will restore the discharge and relieve the distressing pain, but the patient must be kept quiet and the scrotum must be supported in a suspensory. In some cases I have used hot water locally as an adjuvant. While it seems to increase the swelling, it relieves the pain.

In some of these cases there appears to be an absence of symptoms of a subjective character. All you can observe is that the testicle is swollen and exquisitely sore to the touch. The gonorrhoeal discharge has almost if not entirely ceased. In these cases Hamamelis is your remedy.

Clematis is an excellent remedy for gonorrhoeal orchitis when the testicle is indurated and is "as hard as a stone."

Rhododendron also is a useful remedy when the orchitis becomes chronic and the testicle is indurated exactly like Clematis. Under Rhododendron, however, the testicle tends to atrophy. There is also a feeling in the gland as if it were being crushed.

In induration of the testicle you may compare Conium, Arnica, Staphisagria, Spongia, Aurum metallicum, besides the remedies already mentioned. You may give Oxalic acid when there are terrible neuralgic pains in the spermatic cords, worse from the slightest motion, and even on thinking of them.

Ustilago and Hamamelis also cause neuralgia of the testicle. Mercurius is called for when the glands are swollen, and when what little discharge remains is greenish, and when there is phimosis. Pulsatilla is of use in enlargement of the prostate. It is indicated by the mechanical symptom, faeces, when they escape, are small and flat.

PULSATILLA PRATENSIS. 353, Hydrocele, especially the congenital form, may yield to Pulsatilla: Next let us study Pulsatilla in its relations to synovial membranes- Pulsatilla has not an affinity for the true serous membranes, as we found under Aconite and Bryonia, but it acts on the synovial sacs, which are slightly different from the pure serous membranes. The remedy is indicated in rheumatism of the joints, and in gouty, gonorrheal and traumatic synovitis. The joint is, of course, swollen, and the pains are of a sharp stinging character, and are accompanied by a feeling of soreness or of subcutaneous ulceration about the affected joint. The pains in these joint inflammations are usually erratic, nowhere and now there. The tearing pains in the joint force the patient to move the affected part. Pressure relieves. These tearing pains often extend down the limb, and are accompanied by jerking, probably through irritation of the muscular nerves, and are relieved by slowly moving about. I dwell upon these pains because the} 7 so frequently call for Pulsatilla. They are usually worse from warmth, and are relieved by cold. They are worse in the evening.

Pulsatilla rivals Apis in synovitis, but the latter drug has more effusion than the former, and is indicated when there is a great deal of oedema about the joint.

Ledum and Lac caninum have pains worse from warmth. In the former they travel downward; in the latter they shift from one limb to the other and back again.

In rheumatism with erratic pains, you may compare Kali bichromicum, Sulphur and Bryonia.

Chamomilla has stitching pains, jumping from place to place, worse in the knees and ankles, but they are accompanied by numbness and a sense of weakness. The temperament is totally unlike that of Pulsatilla.

Kali bichromicum is called for in gonorrhceal rheumatism. Thepains are better in a warm room.

By reason of its action on the digestive organs, Pulsatilla becomes of value in gout or in the gouty diathesis, especially when the trouble has been brought on by indigestion. If the disease persists despite itsuse, Colchicum follows well.

Now let us consider the action of Pulsatilla on the various organs. We have already studied the mental symptoms of the drug. We have yet to speak of its headaches. These we may summarize as being mostly frontal and supra-orbital. They are generally of uterine,. neuralgic, rheumatic or gastric origin. They are aggravated by mental exertion and by warmth. They are usually worse in the evening, although the gastric symptoms are worse in the morning. When of rheumatic origin, the pains are sharp and seem to go from the head into the face and almost drive the patient mad, so severe are they. In other cases they may be erratic, wandering from one part of the head to the other.

In some cases the headache accompanies menstrual suppression. The head is hot. The pain in the head is better in the open air and * is often accompanied by nose-bleed.

In these headaches you should compare Pulsatilla with the following remedies:

Ranunculus bulbosus, headache on the vertex as if the head were being pressed asunder, worse in the evening and on going from cold to warm air and vice versa.

Ranunculus sceleratus, gnawing in the vertex in a small spot. Cocculus Indicus, pain in the occiput as if it were opening and shutting.

Spigelia, sensation as if the head were open along the vertex. Carbo animalis, feeling on the vertex as if pressed asunder; must 'hold it together.

Veratram album, pressure on the vertex, with pain in the stomach; head relieved by pressing the vertex, and aggravated by motion. Menyanthes , compressive headache in the vertex and sensation when ascending steps as if a weight pressed on the brain, better from pressure, and accompanied by cold hands and feet.

Phellandrium, pain as from a weight on the top of the head, with .achixig and burning in the temples and above the eyes, which are congested; eyes water; can bear neither light nor sound.

The eye symptoms of Pulsatilla, and some of those of the ear, have already been considered. We shall now proceed with the remaining ear symptoms. Pulsatilla has long been known as a remedy for otitis externa or inflammation of the external auditory meatus. The pains are very severe, as indeed they must be from the confined nature of the canal, surrounded as it is by bone. The external ear is swollen and red. The pains are usually worse at night. The trouble may end with otorrhoea, which has the character already described. We come next to the action of Pulsatilla on the female organism. It is here that Pulsatilla has won its laurels. W T e find it indicated in •girls at the age of puberty, when the menstrual flow has not established itself normal^, or has not appeared at all. It is especially at this time that 3 Tou may find soreness of the apices of the lungs, calling for Pulsatilla, and you know that unless you remove this symptom and establish the menstrual flow, your patient will have some form of phthisis. When the menses are established the} T are apt to be too late and too scanty. The flow is fitful in its character, now coming on and now stopping, now appearing as dark clotted blood, and again as an almost colorless watery flow. It is preceded by menstrual colic. The pains are of a crampy, griping character, and so severe that the patient can hardly bear them. She almost smothers if the room is close. She has the Pulsatilla temperament well-marked. Amenorrhcea ma3' call for Pulsatilla when it occurs during the ordinary period of menstruation, or as a result of wet feet, and when nose-bleed acts vicariously for the menses. In some of these cases a single dose will bring on the menstrual flow, while in others you are obliged to give the drug repeatedly.

During pregnane)' you may find use for Pulsatilla. Soreness of the uterus and of the abdominal walls may call for it as well as for Hamamelis.

Then again it may correct malpositions of the foetus in utero, if the cause is not mechanical. Now I know that in making this statement I am venturing on debatable ground. I do not mean to say that Pulsatilla will make the foetus turn around. But I do mean to say that Pulsatilla will act on the muscular walls of the uterus, and stimulate their growth. Sometimes the uterus in its growth during pregnancy develops more on one side than another. Hence there is irregularity in its development, and the foetus must assume an irregular position. Pulsatilla, by alteriug the growth of the uterus, permits the foetus to assume its proper position.

During labor Pulsatilla is called for when the pains are slow, weak and ineffectual. Then, again, we may find the pains spasmodic and irregular, and they may even excite fainting, as in Nux vomica. The patient feels as if smothering, and calls on you to open the windows. Again Pulsatilla may be called for after labor when the placenta remains adherent. In these cases it w T ill not only bring about release of the placenta, but will so tone up the uterus as to avoid post-partum haemorrhage. Cantharis and Gossypium are also useful in this condition.

Again Pulsatilla is many times the remedy in simple retained placenta, which allies it with Sepia, Sabina, Secale and Caulophyllum. Pulsatilla may also be used for after-pains, the temperament agreeing. These pains, however, call more frequently for Chamomilla, Caulophyllum and Xanthoxylum. The last two remedies are particularly useful.

Cuprum metallicum is a good remedy for severe crampy after-pains in women who have borne many children.

Pulsatilla may also be used for scanty or suppressed lochia. It may also be indicated as frequently as Hamamelis in phlegmasia alba dolens, or "milk-leg."

The mammary glands are affected by Pulsatilla before, during, and after pregnancy. It is indicated when mechanical irritation, as, for instance, carrying school-books, excites the flow of milk. After labor you may still give this remedy when the breast is swollen and painful and the flow of milk scanty or absent, the patient being gloomy and tearful.

In this connection I may mention several remedies that are more important than Pulsatilla. I think that Urtica urens is the best remedy for non-appearance of the milk without any other symptoms, there being no apparent reason for the agalactia.

Still another remedy is Ricinus communis or castor oil. This has, when used externally, developed milk. It may also be successful when given internally in low potency.

Agnus castus is useful in agalactia when the mind is greatly depressed.

Causticum is called for in women of a rheumatic diathesis. The face is usually sallow and the patient gloomy and depressed. In its relation to diseases of women, Pulsatilla has a great many allies. First of all we may mention Actea racemosa or Cimicifuga. This remedy resembles Pulsatilla because it acts on the uterus. Both remedies favor normal labor. Here Actea is probably the superior of the two. It also resembles Pulsatilla in its action during labor, being indicated for labor-pains which are very distressing. The symptoms, however, are not intermittent, but rather continuous, and as to temperament, we find Actea racemosa differing from Pulsatilla. For instance, it is indicated in a high degree of nervousness, both during labor and out of labor, during which the woman has an intensely apprehensive mood. She has a dread or fear of something about to "happen, and this haunts her from day to day. At other times she has a dread of undertaking anything, even ordinary work. Actea racemosa is also indicated in any deviation from normal in the position of the uterus when there are sharp cutting pains across the hypogastrium from side to side. It is also to be used for neuralgia reflex from uterine irritation, and that, too, whether it be the nerves of the head, chest or limbs that are involved.

Another remedy to be compared with Pulsatilla is Caulophyllum . This is a remedy that we have not had many years, and yet it is so useful that we would not now be able to get along without it. Its main characteristic is intermittency of pains. If they are neuralgic and reflex from uterine disorder, they are intermittent in character. They are usually sharp and crampy, and appear in the bladder, groins and lower extremities. During labor Caiilophyllum is indicated when there is extreme uterine atony. The pains may be as severe as ever, yet there is apparently no expulsive effort. It is often indicated in nervous women in whom pain seems to be intolerable. The pains are spasmodic and fly about from place to place, now in the groins, then in the abdomen, and next in the chest, never going in the direction of the normal pains. The patient seems to be exhausted. There is great exhaustion of the whole system. She can scarcely speak at times, so weak is the voice. These are symptoms which indicate Caulophyllum. It has been used here by most physicians in the low potencies, although all potencies may be used. It may also be indicated during the last weeks of pregnancy when the patient suffers from false labor-pains, these consisting of painful bearing-down sensations in the hypogastrium. I have known a single dose to stop them after they had lasted for hours.

I have next to speak of Helonias dioica, or the false unicorn, one of the order of Liliaceae. This is one of the new remedies, and it is one which has proved itself worthy of a place by the side of the well-tried Pulsatilla. It is serviceable in females who are run down as to their nervous system; who are easily fatigued by any work and who complain of a tired backache, this tired feeling extending into the limbs. They seem to feel better when they are working than they did when they commenced to work. Now this is not the Rhus tox. condition. It is not due to a limbering up of stiff joints as under the latter remedy. The reason for the symptom is, that some of the languor passes off as the patient continues her labors. The backache is usually situated in the lumbar region just over the site of the kidneys, or it may appear lower down and affect the sacral region. Pain in either of these locations may accompany uterine disturbances. You will find also that Helonias is useful for suppression of the menses (here it is closely akin to Pulsatilla)

, when the kidneys are congested. It seems as if the monthly congestion, instead of venting itself as it should through the uterine vessels, has extended to the kidneys, giving rise to albuminuria. The urine is scanty and turbid. Then, again, you find Helonias called for after confinement, when there is a tendency to prolapsus and other malpositions of the uterus. The patient complains of heaviness and dragging in the pelvic region. There is a sensitiveness which has been expressed as ' ( consciousness of the existence of a womb." You know that we are not conscious of our internal organs. They move and perform their respective functions without any sensation. The minute our sensations tell us that we have a stomach or liver, that minute we begin to have disease there. Accompanying these symptoms of prolapsus and of uterine over-sensitiveness is apt to be too long-lasting lochia, if I may -use that term. To be more exact, I should say that there is a sanguineous discharge, which continues for weeks after confinement. I can recall a case which I treated last winter. It was that of a lady who gave birth to a very large child, and suffered afterward from prolapsus uteri. I gave her several remedies without relieving her, so that at the end of three months she was still uncured. About this time she began to complain of tightness across the chest, with cough and some little bloody sputum. Her mother had died of phthisis after giving birth to twins, so I feared serious lung affection. Phosphorus did no good; Nux did no good. I studied up the case more thoroughly. She told me that she felt as though there were a heavy weight over the chest on the sternum, and a feeling as though the chest had been gripped in a vise with the sore feeling which follows. This annoyed her when she awakened at night. These symptoms were symptoms which had been noticed only in the male provers of Helonias. Nevertheless I gave that drug, and it entirely removed both the chest symptoms and the prolapsus. Then, again, under Helonias you frequently find a tendency to inflammation of the vulva and vagina with formation of pus. You may also use it in ulceration of the cervix uteri. With this there is a leucorrhoea which has a bad odor, and every little exertion tends to produce a flow of blood. With these symptoms there is almost always. persistent itching about the genitals with or without the formation of blisters or sores. We know little or nothing concerning the value of Helonias during labor.

A drug to be placed by the side of Helonias is Senecio aureus. This drug causes inflammation of mucous membranes, hence it is useful when there is a tendency to catarrh of the nose, throat and lungs, particularly in women. It is especially suited to nervous, excitable women who suffer much from sleeplessness, traceable to uterine irritation, as from prolapse or flexion of the uterus. The patient suffers from scanty menstruation, and she is apt to be tearful. There is dry teasing cough, with stitching pains in the chest and blood-streaked sputum. The bladder sympathizes with the uterine disease. There is much pain at the neck of the bladder causing burning and tenesmus. After the onset of the menstrual flow the chest and cystic symptoms become modified or cease, thus showing how intimately they are related to the irregularity in the menstrual effort.

Another drug is Aletris farinosa. This is one of the most bitter substances known. It is closely allied to Senecio and Helonias. In allopathic parlance it is a "tonic." It is especially useful in women who, in addition to uterine trouble and leucorrhoea, have extreme constipation, great effort being required to effect an evacuation from the bowels. There is great accumulation of frothy saliva. Aletris is a remedy also for weakness of digestion; food distresses the patient and lies heavily in the stomach.

Cyclamen is very similar to Pulsatilla. The}- are both suited to chlorotic and anaernic women, and they both have some trouble with the digestion, and intolerance of fatty foods. The menstrual colic and irregularities are almost identical in the two drugs. The same kind of melancholy is common to both. Cyclamen may be distinguished from Pulsatilla by the following symptoms. Generally, but not always, there is more thirst with the Cyclamen patient. The Pulsatilla patient feels better in the open air, the Cyclamen does not. The Cyclamen patients suffer from a peculiar kind of torpidity, both of mind and bod}-, with languor. They cannot think. They are better when aroused and forced to exercise, something like Helonias. When they get up in the morning they feel so heavy and languid that they feel as though they could scarcely go through the day's duties, but when they once get to work they go on tolerably well until night time.. That is Cyclamen, and it is very much like Helonias. They suffer, too, from dulness of the senses with flickering before the eyes. You often find this in weak anaemic women. They see various colors before the eyes, very much as under Santonin, Conium, Kali bichromi- €um } etc. Sometimes they have half-sight. The indigestion with which they are troubled has this to characterize it: formation of flatus which causes colic at night, forcing the patient to get up and walk about till the flatus passes and gives relief.

It yet remains for me to speak of Hydrastis Canadensis. This is a remedy which acts even more powerfully on mucous membranes than does Pulsatilla. It causes catarrh of the mucous membranes of the nose, stomach, bowels, bladder, uterus and vagina, the discharge, however, being more acrid than it is under Pulsatilla, and of a thick yellow or bloody appearance; in uterine affections Hydrastis is indicated for prolapsus uteri with ulceration of the cervix. The leucorrhoea is watery at times, and a,t other times thick, yellow and excoriating; this condition being associated with gone, weak feeling at the pit of the stomach and well-marked palpitation of the heart. The tongue is moist, and coated a dirty yellow color, and takes the imprint of the teeth. The face is sallow, and the eyes are sunken and surrounded "by dark rings. The bowels are apt to be constipated, the stools being coated or intermixed with mucus.

lastly may be mentioned Lilium tigrinum, which helps in uterine complaints when there are sharp pains across the abdomen from one ilium to the other; in addition there are marked bearing-down pains, making the patient cross her limbs. She places her hand over the vulva to support the viscera.

Pulsatilla cures a fever with these symptoms: the head is hot and the lips are dry; the patient is constantly licking his lips to moisten them, yet he does not wish to drink. It may also be used in intermittent fever after the abuse of quinine when thirst appears at two or three o'clock in the afternoon; then comes chill without thirst, and anxiety and oppression from venous congestion of the chest. The patient is sleepy, yet she cannot sleep. Sometimes one hand is hot and the other cold.

Pulsatilla acts on the larynx, causing hoarseness which comes and goes capriciously. Such a hoarseness frequently marks the termination of a " cold," and this remedy may prevent its becoming chronic. It also cures purely nervous hoarseness appearing with every emotion. In the chest we again have symptoms of a catarrhal nature. Bronchitis with thick yellow expectoration; or dry, tickling cough from irritation in the trachea, worse in the evening and on lying down, with dry air passages or a scraped, raw feeling. Occasionally there is dyspnoea or constriction of the chest.

I warn you not to select Pulsatilla for a loose cough unless you are sure that all the symptoms of the case call for it. It often tightens such a cough without curing it.

Bloodspitting has already been mentioned. This may be vicarious or it may belong to incipient consumption. In the latter case there may be added soreness in the chest, worse under the clavicles; burning in the chest, especially in the region of the heart; stitches in the sides of the chest.

Pulsatilla Nuttalliana has sharp pains below the left arm-pit near the back.

In dry night-cough compare Hyoscyamus, Comum, Actea racemosa, Laurocerasus , B?yo?iia, etc.

Pulsatilla is indicated in measles, but I think that it is often given in the wrong place. It is indicated when the catarrhal symptoms are prominent and we have coryza and profuse lachrymation. The cough is usually dry at night and loose in the day time. The child sits up in bed to cough. It may also be used when there is earache. Do not give Pulsatilla in the beginning when the fever is high. You should begin the case with Aconite or Gelsemium. The eruption may come out to its full extent or it may have a dusky appearance. Kali bichromicum is to be used when, instead of simple catarrh of the eyes, you have pustules developed on the cornea. The throat is swollen and pains go from the throat into the ears; the saliva^ glands are swollen, and there is catarrhal deafness.

In neuralgia, Pulsatilla is indicated when the pains are jerking, erratic and paroxysmal, and as they continue they become more and more unbearable.

Spinal irritation is also an indication for the drug. The neck, and in fact the whole body, feels as stiff as a board. The small of the back feels as if tightly bandaged. There are pains in the sacral region, worse on sitting and when bending backward. The joints feel weak, as if they would become readil}* dislocated. Rest relieves these symptoms, hence the patient is better after sleep.

In backache, worse from sitting, you may think of Zincum, Cobalt, Sepia, Cannabis Indica, Agaricus, Berberis, Rhus tox., Valerian, etc. The sleep symptoms of Pulsatilla are very characteristic. The sleep is restless with frequent waking and troubled dreams; on waking the patient is dull and listless.

In sleep symptoms Pulsatilla and Nux vomica differ very much. While the former is wide awake and full of ideas in the evening, Nux is sleepy in the evening. The Nux patient awakes at three or four o'clock in the morning feeling rested. Then he goes to sleep again and awakes at the usual time feeling a great deal worse. Cocculus has sleeplessness from pure mental activity. Ailments follow very slight deprivation of sleep.

Sulphur has " slightest noise at night awakens the patient."

Weeps easily. Timid, irresolute. Fears in evening to be alone, dark, ghost. Likes sympathy. Children like fuss and caresses. Easily discouraged. Morbid dread of the opposite sex. Religious melancholy. Given to extremes of pleasure and pain. Highly emotional. Mentally, an April day.

Wind Flower The weather-cock among remedies. The disposition and mental state are the chief guiding symptoms to the selection of Pulsatilla. It is pre-eminently a female remedy, especially for mild, gentle, yielding disposition. Sad, crying readily; weeps when talking; changeable, contradictory. The patient seeks the open air; always feels better there, even though he is chilly. Mucous membranes are all affected. Discharges thick, bland, and yellowish-green. Often indicated after abuse of Iron tonics, and after badly- managed measles. Symptoms ever changing. Thirstless, peevish, and chilly.

When first serious impairment of health is referred to age of puberty. Great sensitiveness. Wants the head high. Feels uncomfortable with only one pillow. Lies with hands above head.

Worse, from heat, rich fat food, after eating, towards evening, warm room, lying on left or on painless side when allowing feet to hang down. Better, open air, motion, cold applications, cold food and drinks, though not thirsty.

Wandering stitches about head; pains extend to face and teeth; vertigo; better in open air. Frontal and supra-orbital pains. Neuralgic pains, commencing in right temporal region, with scalding lachrymation of affected side. Headache from overwork. Pressure on vertex.

Right-sided neuralgia, with profuse lachrymation. Swelling of lower lip, which is cracked in middle. Prosopalgia towards evening till midnight; chilly, with pain.

Thick, profuse, yellow, bland discharges. Itching and burning in eyes. Profuse lachrymation and secretion of mucus. Lids inflamed, agglutinated. Styes. Veins of fundus oculi greatly enlarged. Ophthalmia neonatorum. Subacute conjunctivitis, with dyspepsia; worse, in warm room.

Sensation as if something were being forced outward. Hearing difficult, as if the ear were stuffed. Otorrhœa. Thick, bland discharge; offensive odor. External ear swollen and red. Catarrhal otitis. Otalgia, worse at night. Diminishes acuteness of hearing.

Coryza; stoppage of right nostril, pressing pain at root of nose. Loss of smell. Large green fetid scales in nose. Stoppage in evening. Yellow mucus; abundant in morning. Bad smells, as of old catarrh. Nasal bones sore.

Greasy taste. Dry mouth, without thirst; wants it washed frequently. Frequently licks the dry lips. Crack in middle of lower lip. Yellow or white tongue, covered with a tenacious mucus. Toothache; relieved by holding cold water in mouth (Coff). Offensive odor from mouth (Merc; Aur). Food, especially bread, tastes bitter. Much sweet saliva. Alternations of taste, bitter, bilious, greasy, salty, foul. Loss of taste. Desire for tonics.

Averse to fat food, warm food, and drink. Eructations; taste of food remains a long time; after ices, fruits, pasty. Bitter taste, diminished taste of all food. Pain as from subcutaneous ulceration. Flatulence. Dislikes butter (Sang). Heartburn. Dyspepsia, with great tightness after a meal; must loosen clothing. Thirstlessness, with nearly all complaints. Vomiting of food eaten long before. Pain in stomach an hour after eating (Nux). Weight as from a stone, especially in morning on awakening. Gnawing, hungry feeling (Abies c). Perceptible pulsation in pit of stomach (Asaf). All-gone sensation, especially in tea drinkers. Waterbrash, with foul taste in the morning.

Painful, distended; loud rumbling. Pressure as from a stone. Colic, with chilliness in evening.

Rumbling, watery; worse, night No two stools alike. After fruit (Ars; Chin). Blind hæmorrhoids, with itching and sticking pains. Dysentery; mucus and blood, with chilliness (Merc; Rheum). Two or three normal stools daily.

Increased desire; worse when lying down. Burning in orifice of urethra during and after micturition. Involuntary micturition at night, while coughing or passing flatus. After urinating, spasmodic pain in bladder.

Orchitis; pain from abdomen to testicles. Thick, yellow discharge from urethra; late stage of gonorrhœa. Stricture; urine passed only in drops, and stream interrupted (Clemat). Acute prostatitis. Pain and tenesmus in urinating, worse lying on back.

Amenorrhœa (Cimicif; Senec; Polygon). Suppressed menses from wet feet, nervous debility, or chlorosis. Tardy menses. Too late, scanty, thick, dark, clotted, changeable, intermittent. Chilliness, nausea, downward pressure, painful, flow intermits. Leucorrhœa acrid, burning, creamy. Pain in back; tired feeling. Diarrhœa during or after menses.

Capricious hoarseness; comes and goes. Dry cough in evening and at night; must sit up in bed to get relief; and loose cough in the morning, with copious mucous expectoration. Pressure upon the chest and soreness. Great soreness of epigastrium. Urine emitted with cough (Caust). Pain as from ulcer in middle of chest. Expectoration bland, thick, bitter, greenish. Short breath, anxiety, and palpitation when lying on left side (Phos). Smothering sensation on lying down.

Shooting pain in the nape and back, between shoulders; in sacrum after sitting.

Drawing, tensive pain in thighs and legs, with restlessness, sleeplessness and chilliness. Pain in limbs, shifting rapidly; tensive pain, letting up with a snap. Numbness around elbow. Hip-joint painful. Knees swollen, with tearing, drawing pains. Boring pain in heels toward evening; suffering worse from letting the affected limb hang down (Vipera). Veins in forearms and hands swollen. Feet red, inflamed, swollen. Legs feel heavy and weary.

Urticaria, after rich food, with diarrhœa, from delayed menses, worse undressing. Measles. Acne at puberty. Varicose veins.

Wide awake in the evening; first sleep restless. Wakes languid, unrefreshed. Irresistible sleepiness in afternoon. Sleeps with hands over head.

Chilliness, even in warm room, without thirst. Chilly with pains, in spots, worse evening. Chill about 4 pm. Intolerable burning heat at night, with distended veins; heat in parts of body, coldness in other. One-sided sweat; pains during sweat. External heat is intolerable, veins are distended. During apyrexia,

headache, diarrhœa, loss of appetite, nausea.

Penthorum, often indicated after Pulsatilla in later colds. Ionesia Asoca-Saraca indica––(Amenorrhœa. Menorrhagia-acts powerfully on female organs. Abdominal pain). Atriplex (Uterine symptoms, amenorrhœa; hysteria, coldness between shoulders, dislike of warm food, craves strange foods, palpitation, sleeplessness). Pulsatilla Nuttaliana, identical effects. Compare: Cyclamen; Kali bich; Kali sulph; Sulphur. Pimenta-Allspice––(one- sided neuralgias, parts of body hot and cold). Anagyris (headache, amenorrhœa). Complementary: Coffea; Chamom; Nux.

Third to thirtieth attenuation.

Pulsatilla

It is said to be a very good medicine for women, for blondes, especially for tearful blondes.

Mind: It is one of the polychrests and one of the medicines most frequently used, as well as often abused.

The Pulsatilla patient is an interesting one, found in any household where there are plenty of young girls.

She is tearful, plethoric, and generally has little credit for being sick from her appearances; yet she is most nervous, fidgety, changeable, easily led and easily persuaded. While she is mild, gentle and tearful, yet she is remarkably irritable, not in the sense of pugnacity, but easily irritated, extremely touchy, always feels slighted or fears she will be slighted; sensible to every social influence.

Melancholia, sadness, weeping, despair, religious despair, fanatical; full of notions and whims; imaginative; extremely excitable. She imagines the company of the opposite sex a dangerous thing to cultivate, and that it is dangerous to do certain things well established in society as good for the human race.

These imaginations belong to eating as well as thinking. They imagine that milk is not good to drink, so they will not take it. They imagine that certain articles of diet are not good for the human race. Aversion to marriage is a strong symptom. A man takes it into his head that it is an evil thing to have sexual intercourse with his wife and abstains from it.

Religious freaks; an especial tendency to dwell on religious notions; fixed ideas concerning the Scripture; he misuses and misapplies the Scriptures to his own detriment; dwells on sanctification until he becomes fanatical and insane; thinks he is in a wonderfully sanctification state of mind, or that he has sinned away his day of grace.

This goes no until he becomes insane on other subjects, and then the tendency is to sit day after day in a taciturn way. He will not answer questions unless hard pressed, when all he will say is "Yes" or "No," or be will merely shake his head. Puerperal insanity in a woman who was mild, gentle and tearful, later sad and taciturn, and then she sits in her chair all day answering nothing or merely nodding her head for "Yes" or "No."

Many of the complaints are associated with weakness of the stomach and indigestion, or with menstrual disorders. Women who abort; various irregularities of the menstrual flow; false conception. The mental symptoms are often associated with the ovarian and uterine difficulties.

With such a mental state the general state of the body is worse in a warm room and, relieved by motion. Tearful, sad and despondent, ameliorated walking in the open air, especially when it is crisp, cool, fresh and bright. Suffocation and an increase of the pains, and even chilliness in a warm room; a nervous chilliness when the patient perspires from the heat of a room. The inflammatory symptoms, neuralgias and rheumatisms are relieved by a cold, by eating and drinking cold things, by cold applications, or cold hands. Cold drinks relieve, even though the patient is not thirsty. Cold foods are digested while hot food make the body warm from which symptoms are worse. Ice cold water feels good going down the oesophagus, and is retained in the stomach, though there is not thirst.

Modalities: Many symptoms worse after eating. It is often only a lump in the stomach, but the mental and nervous symptoms also are worse after eating. The stomach symptoms are worse in the morning, the mental symptoms worse in the evening. Aggravation from fats and rich foods.

Complaints brought ort by eating fat, pork, greasy things. cakes, pastries and rich things. The Pulsatilla stomach is slow to digest. Hours after eating there is a sense of fullness in the stomach, a lump in the stomach, ameliorated by slow walking in the open air.

The patient is commonly relieved from slow motion in the open air, becomes frantic when trying to keep still, worse during rest, ameliorated by doing something, generally slow, moderate motion. This relief from motion and aggravation from rest, relief in the open air, and aggravation in a warm room give us a good summary of this beautiful remedy.

In Pulsatilla patients the skin feels feverish and hot, while the temperature of the body is normal, There is aggravation from much clothing; she wants to wear a thin dress even in moderately cold weather. Does not need to dress warmly. Much clothing and covering aggravate. Often be cannot wear flannels or woolen clothing because they irritate the skin, causing itching and eruptions like Sulphur, and this is not surprising, as Pulsatilla and Sulphur are antidotes. There is no remedy like Pulsatilla to antidote Sulphur when it has been used every Spring to "cleanse the blood."

Some people use Sulphur until the skin becomes red, hot, easily irritated, and aggravated by clothing. Pulsatilla is the antidote. Old cases of psoriasis; little flat, brownish patches about the size of the thumb nail, which itch tremendously, in old Sulphur patients are cured by Pulsatilla. A general feature of the skin is itching and burning, but a more marked Pulsatilla state is a Lachesis appearance of the skin. It is mottled, erysipelatous; spotted, purplish in spots; veins engorged; capillaries tumid; a vasomotor paralysis of the capillaries or veins producing a mottled appearance. Pulsatilla has an unusually venous constitution.

Veins: The veins are engorged, in a state of stasis, hence there is over-heat of the skin. This unusual fullness, redness and purple aspect of the face is a false plethora. it often goes on to a puffiness and swelling, and especially at the menstrual periods. Considerable bloating of the face and eyes, bloating of the abdomen; feet puffed so that she cannot wear shoes, feet red and swollen at the menstrual period, ameliorated by the menstrual flow.

Many women are late and are preparing for a week or ten days; face purple, red, puffed and bloated; abdomen distended; dyspnoea; and all this is relieved by the menstrual flow. She feels these symptoms perhaps one or two weeks, and is relieved by slow motion in the open air. Cannot breathe in a warm room; wants the windows open; chokes and suffocates in a warm bed at night. This increases until the menstrual flow starts. The stomach is so full and distended that she cannot eat. No appetite or desire for food.

With the engorgement of veins ulcers surrounded by varicose veins are common in this remedy. Ulcers bleed black blood which coagulates early; little black clots; bleeding is not copious; clots easily, dark, tarry, offensive. Ulcers bleed and ooze, discharge a bloody watery fluid or there is a very thick yellow or green flow.

This brings us to the catarrhal state. Wherever there is mucous membrane there is catarrh. The mucous membrane is covered with purple spots, dry spots; tumid, puffed, looks erysipelatous. Wherever there is inflammation of the mucous membrane it looks purple; a venous congestion. Thick, green, yellow catarrhal discharges are most characteristic. The catarrhal discharges are bland with the exception of that from the vagina, which is excoriating, causing rawness of the parts. From the eyes, ears, nose and chest there arc thick, yellow, green, bland, discharges, but there is thick yellow green excoriating leucorrhoea. Remember, however, that Pulsatilla has a bland leucorrhoea, in keeping with the general state. Discharges are often offensive, sometimes bloody, watery, but even then mingled with yellow green purulent fluid.

Eyes: The Pulsatilla patient suffers from vertigo from affections of the eyes, ameliorated by wearing well-adjusted glasses; attended by nausea which is worse lying down, worse from motion, worse from the motion of the eyes, and ameliorated in a cold room, and by riding in a carriage in the cold air. As soon as she enters a room that is warm she has nausea, even to vomiting. Vertigo with vomiting after eating.

Head: Pulsatilla has violent headaches. Headaches in school girls who are about to menstruate. Headache accompanying menstruation. Headache associated with suppressed menses, with menstrual disorders; not caused from them, but associated with them. Pains through the temples and sides of the head are common Pulsatilla headaches. Headaches before, during and after menstruation; but more commonly before, when there is a general state of congestion, stasis, and tumefaction of the veins, and amelioration of the headache when the menses set in if the flow is normal. It is common to have the head and nervous symptoms through the menses, because the flow is so scanty, often little more than a leucorrhoea, and for a single day a little clot of dark blood. One-sided headaches and one-sided complaints are peculiar to Pulsatilla. Perspiration on one side of head and face; fever on one side of the body; one side cool and normal and the other side hot. I remember a case of puerperal fever with sweat on one side of the body and dry heat on the other and confusion of other symptoms. Pulsatilla was given and the patient recovered.

The Pulsatilla headache is a throbbing congestive headache; much, heat in the head, ameliorated by the application of cold, by external pressure, and sometimes by slow motion, aggravated by lying and sitting quiet, ameliorated by walking slowly in the air; becomes worse towards evening and gradually increases through the evening and night, worse from the motion of the eyes and from stooping. The pains are often constricting, throbbing and congestive. Periodic sick headaches, with vomiting of sour food. Headache when be overeats. Though he likes ice cream, he has headache and congestion of the stomach after eating ice cream.

Eyes. Catarrhal symptoms. Pustules about the lids and over the ball; on the cornea. Inflammatory features. Thick, yellow-green pus. Granular lids. Continued formation of little pustules. Isolated granules on lids, grow out here and therein bunches as large as pin leads. Eyelids inflamed and bleed easily. Every time he catches cold it settles in the eyes and nose. Eyes red, inflamed, and discharge, In infants catarrhal diseases of the eyes of a gonorrheal character; ophthalmia neonatorum. In early days the infant often needs the same constitutional remedy as the mother. Yellow green discharge from the eyes; eyes are ameliorated by washing in warm water, or tepid water; even cold water feels good to the eyes.

The Sulphur patient is made worse by bathing; the eyes smart, burn and become increasingly red after washing in water. Pulsatilla causes a tendency to the formation of styes; recurrent styes; always having styes. Pustules, papules and little nodosities on the lids.

Prior to menstruation, in young girls especially, things get black, before the eyes, like a gauze or a veil. Nervous manifestations, twitchings, spell of blindness and fainting. In the early stages of paralysis of the optic nerve Pulsatilla is a great remedy. The patient is always rubbing the eyes; whether or not there is mucus in the eyes it matters not; but it is a sensation of gauze before the eyes, ameliorated by rubbing.

Pulsatilla has cured incipient cataract. Itching of the eyes, in keeping with the skin symptoms. Itching in the ears, nose, tickling in the throat, in the larynx.

Ears: In the ears we have the same catarrhal condition.

Thick, yellow, offensive, purulent, bland discharge; very foetid, sometimes bloody. Pulsatilla is commonly indicated in earache of children; when the child, is a gentle, fat, plump, vascular red-faced child always pitifully crying. If it is a case of earache in a nondescript child Pulsatilla will also prove to be a temporary remedy, so closely is it related to pain in the ear. Pains in the ears in the evening or in the night, ameliorated by walking slowly about the room. In Chamomilla you have a snap. ping and snarling child, never pleased, scolds the nurse and mother ameliorated by walking about. The irritability decides for Chamomilla. You can detect a pitiful cry from a snarling mad cry. Both are ameliorated by motion, by being carried. Both want this and that and are never satisfied; they want amusement. But the Pulsatilla child when not amused has a pitiful cry and the Chamomilla child a snarling cry. You will want to caress the one and spank the other.

Ear troubles with a ruptured drum and no healing; otitis media. Abscess in the middle ear; inflammation of the middle ear; copious thick bloody discharge, then yellow-green. The case goes on night and day until rupture takes place. I have found this condition as an endemic, in which Merc., Hep.., and Puls. were the most frequently indicated remedies.

Ear troubles following eruptive diseases. Offensive catarrhal discharge dating back to scarlet fever or measles; badly treated and drugged patients. Inflammation and swelling of the external ear; erysipelatous purple conditions. Scabs on the tragus.

Nose: The patient is subject to repeated attacks of coryza, with sneezing and stuffing up of the nose; a febrile state; sometimes with chills, fever and sweat.

Pains in the face through the nose. In the evening considerable watery discharge with sneezing; in the morning stuffing up of the nose with thick yellow-green discharge. Pulsatilla is suitable to chronic catarrhs, with thick yellowgreen discharge which is bland; stuffing up of the nose; copious discharge; patient has a bad smell in the nose; smells various offensive things, sometimes like manure, but more commonly described as the offensiveness of a stinking catarrh.

Large bloody, thick, yellow crusts accumulate in the nose, harden down and are blown out in the morning, accompanied by thick yellow pus. In old lingering cases, loss of smell and taste. The mucous membrane is in a state of thickening and suppuration, with the formation of crusts and ulcers. Fullness high in the nose; stuffing up and fullness in the posterior nares. Hawks up thick yellow mucus in masses, with crusts in the morning, very often offensive to others. Many Pulsatilla patients in this catarrhal state get relief from this horrible stench by blowing out great crusts. Thick clinkers of dried up pus or dried mucus and pus accumulate for several days and this terrible catarrhal smell comes on; but as soon as he blows out these clinkers the odor goes away and he has relief until they form again in a few days.

The patient himself feels better in the open air, and worse in a warm room. He breathes better in the open air; feels stuffy in a warm room. But there are times when his nose stuffs up more in a warm room, where he sneezes more in a warm room, The loss of smell is present in chronic and acute catarrhs. Much stuffing up of the nose occurring in the evening; he blows the nose easily and cleans it out during the day, but it stuffs up in the evening and he cannot clear it out. Remember that the mental symptoms are worse in the evening. He gets up in the morning with a stuffed up nose, but can clean it out; his mouth is foul, tongue coated, rancid taste, requires much brushing of his teeth and washing out of his mouth before he can take his breakfast. So you see the mouth and stomach symptoms are worse in the morning, the mental symptoms are worse in the evening and there is also a stuffing up of the nose in the evening. Compare this with the cough. There is a dry evening cough in Pulsatilla and a loose morning cough. Copious expectoration in the morning, but a dry, tight, constricted feeling in the chest in the evening. Stuffed up in the evening, making breathing difficult. To repeat, then, Pulsatilla is one of our sheet anchors in old catarrhs with loss of smell, thick yellow discharge, and amelioration in the open air; in the nervous, timid, yielding, with stuffing up of the nose at night and copious flow in the morning.

With the catarrhs and acute colds there is often bleeding of the nose, blowing blood from the nose; the crusts cling tight, and when blown out they are torn loose, and this causes bleeding; but the nose bleeds easily, subject to epistaxis. Nose-bleed during the menstrual period; nosebleed before the menstrual period; nose-bleed with suppressed menses; bleeding dark, thick, clotted, almost black, venous blood.

Especially do we find catarrhal subjects in women who have late, scanty, light colored menses; scarcely more than a leucorrhoea; if bloody, then only a little black stain or clot. Chlorotic patients who have their menses once every two or three months; chlorotic girls who are irregular, and are subject to these catarrhal states.

Pulsatilla is very useful in hay fever. The management of hay fever requires considerable study because you have to deal with the troublesome imaginations of the patient, he will refuse to let you study him; he wants the hay fever treated; he don't want the hemorrhoids, the thick skin on the soles of the feet, the pains in the sacrum, the diarrhea which alternates with constipation, talked about or inquired into; these are always better when the hay fever is present. Sometimes he will tell you that he is always well except when he has hay fever. He may feel well, but it is impossible for him to be well; he has always had these complaints and he does not want you to bother with them. The hay fever will hardly ever reveal the indications for a remedy for the patient.

Another individual has epilepsy, and if you expect to find in the fit the remedy that cures the patient you will be mistaken. When an acute mimicking manifestation of disease follows several times the same beaten track the details are hard to find. He does not know much about his hay fever. If you suggest several things he has them all. In nearly all these acute expressions you do not find in the exaggerated attack the symptoms that will lead you to the remedy.

You will find these symptoms by getting the state of the patient before he was taken with bay fever. These primitive symptoms are of more importance. Sometimes it is important to know what region was affected before the nose was affected. At times you will find spinal symptoms; great soreness in the back relieved by lying on something hard. Few remedies have that. They do not tell you that at first but continue to dwell on the bay fever. In many nervous women the attack comes on with sneezing and watery discharge and then a copious, thick, yellowishgreen discharge. These are the natural symptoms of hay fever, but in the "back" symptoms you see something.

In Pulsatilla the menstrual symptoms and the prolapsus come in. When the hay fever comes on, all the other symptoms are better, she feels nothing except the hay fever, however, all the symptoms interweave with each other.

The Natrum mur. symptoms will be worse in the morning and until toward noon, while in Pulsatilla they are worse in the evening, the nose filling up with thick, yellowish-green, ropy mucus, and when the nose has been cleared, a dry, burning, smarting feeling remains; if the room is warm at night, she cannot sleep.

Natrum mur. is a little like that in the smarting and inability to sleep at night in a warm room. In Natrum mur. too, the discharge may continue day and night. We have an acute class in which Pulsatilla is sometimes indicated-copious watery discharge which ends in sneezing. In the beginning we will think of Carbo veg., Arsenic, Allium cepa, Euphrasia.

With Carbo veg. there is a watery discharge and the irritation extends into the chest, with hoarseness and rawness. In Allium cepa we have one group of symptoms that points to this remedy. Excoriating discharge from the nose and bland discharge from the eyes; in the larynx, sensation as if hooks were there, and sometimes this extends below the larynx; this always means Allium cepa; it is also worse in a warm room like Puls.

The Euphrasia looks like Cepa, only the discharge from the eyes is copious, watery and burning the lachrymation burns the eyes and excoriates the cheeks; discharge from nose is bland like Pulsatilla; sometimes this goes into the chest, then it is no longer Euphrasia.

Iodine is worse in a warm room; thick discharge from nose which bums and excoriates and is yellowish-green; but there is one thing that differentiates it from all the others -the patient immediately begins to emaciate when the complaint comes on and is very hungry. Kali hydr. with the thick yellowish discharge, worse in a warm room, there is a great amount of rawness and burning in the nose; external nose very sore to pressure; sensitiveness in the root of the nose; whole face aches and patient is extremely restless; wants to walk in the open air which does not fatigue him.

Iodide of Arsenic; anxiety, restlessness and weakness; frequent sneezing and copious watery nasal discharge that burns the lip. Burning, watery discharge from the eyes like Arsenic. Arsenic wants to be very warm; wants hot water applied to the eyes; the only relief is from sniffing hot water up the nose. The Iodide of Arsenic is worse in a warm room, and, for days after sneezing, the discharge thickens and becomes gluey, looking like thick yellow honey, this excoriates; much pain through the root of the nose and eyes; often rawness in the chest with dyspnoea.

The remedies having the dyspnoea are Arsenic, Iodide of Arsenic, Iodine, Kali hydr., and Sabadilla; these are the ones I have found most frequently indicated in the asthmatic forms of hay fever. If the complaint has been developed after being overheated about that time, you will find that Silica, Puls. and Carbo veg. must be carefully compared.

There is another class of remedies having the stuffing up of the nose not relieved by the discharge. There is a constant duke to blow the nose, yet he gets no relief. This makes me think at once of Lach., Kali bi., Psor., Naja and Sticta. Psorinum has the copious, watery, bland discharge from the nose, it may be excoriating, it has both. The stuffing up of the nose generally takes place in the open air; he is relieved in a warm, close room, and by lying down; has sonic dyspnoea. which is relieved by stretching the arms at right angles with the body. Hay fever is a psoric sickness. Psorinum given in a single dose will so develop the symptoms that the case will be more clear. The attack is not the best thing to prescribe for. If it is too violent, a short acting remedy may be selected that will mitigate it.

Nux vomica has a free easy breathing in the open air, but when he goes into the warm room his nose stuffs up, which also occurs at night, though the water drips on the pillow yet he stuffs up like Puls., Bry., and the Iodine preparations Iodide of Arsenic and Cyclamen. Do not understand me to have given remedies for hay fever, we cannot lay down remedies for diseases. The whole constitution must be most carefully examined.

Face: The face is sickly, often mottled, purple, intermixed with yellow and unhealthy colors; venous puffing; sensation of fullness; often a red face, like that of health, and the patient gets no sympathy; face often flushes; flushes of heat to the face; at times a sunken look; dark rings about the eyes; sallow, green, chlorotic. Subject to erysipelas; erysipelatous blotches on the face, spreading to the scalp, with stinging and burning; skin of face very sensitive to touch at such times.

Mumps and inflammation of parotid glands. If a woman suffering with mumps takes a decided cold the breasts swell, and there is an inflammation of the mammary gland. Girls take cold, the swelling of the parotid subsides too soon, and the corresponding mammary gland swells; sometimes both swell; or it may begin in one and go to the other.

In men it is the testicle. Pulsatilla is one of the most important remedies in this form of metastasis; it breaks up complaints that flit about. Pulsatilla is the common remedy for enormously swollen testicles from mumps in a boy. Carbo vegetabilis is another remedy, but then you have a Carbo veg. patient. Abrotanum is also useful in wandering around symptoms.

Pains: Pulsatilla has wandering pains, rheumatism goes from joint to joint, jumps around here and there; neuralgic pains fly from place to place; inflammations go from gland to gland.

But here is the distinguishing feature - Pulsatilla sticks to its own text; it keeps jumping around, but it does not change to a new class of disease. Abrotanum has this metastasis, but it changes the whole diagnosis; that is, the allopath says, "This is a new disease today."

The patient has a violent diarrhoea today, and an ignoramus suppresses it; an inflammatory rheumatism comes on, and he calls it a new disease. The suppression of a diarrhoea or a hemorrhage, or the removal of piles, causes an out-cropping somewhere else. A child has a summer complaint suppressed and there follow symptoms referring to the brain, kidneys, liver, or a marasmus with emaciation from. below upwards. Such things are in the nature of Abrotanum.

Stomach: Hours after eating the patient eructates mouthfuls of sour, rancid, bitter fluid; liquids roll up from the stomach; always belching up rancid food.

Some patients cannot digest butter; cannot use olive oil on their food. All sorts of bad tastes in the mouth. Several hours after eating has not finished digesting food in the stomach. Sour vomiting and eructations.

Digestion is slow, and the patient goes to the next meal hungry; eating does not satisfy; assimilation is bad. Always bilious. Mouth is slimy and the taste is bad. All these symptoms are worse in the morning.

"Accumulation of saliva and much mucus in the mouth."

"Flow of sweetish or tenacious saliva." "Constant spitting of frothy, cotton-like mucus." A striking feature of the Pulsatilla patient is that he never wants water. Dryness of the mouth, but seldom thirsty. Even in -many of the fevers he is thirstless, but there is at times an exception to this in high fevers there may be some thirst. "Thirstlessness, with moist or dry tongue. Desire for sour, refreshing things."

Often desires things he cannot digest; lemonade, herring, cheese, pungent things, highly-seasoned things, juicy things.

"Aversion to meat, butter, fat food, pork, bread, milk, smoking."

"Scraping sensation in stomach and oesophagus like heartburn."

Many pains in the stomach when empty or when full. But the bloating, the gas and the sour stomach are most striking. Gastric catarrh. Craves ice cream; craves pastries, yet they will not digest, and make him worse. Craves things which make him sick. This is not uncommon. The whisky drinker craves his liquor, yet knows it will kill him. So in Pulsatilla with regard to pastries. Craves batter cakes, with maple syrup, yet knows they will be vomited. Craves highly spiced sausage, yet averse to pork alone.

Pulsatilla produces and cures jaundice. "Jaundice in consequence of chronic susceptibility to hepatitis and derangement of secretion of bile, with looseness of bowels duodenal catarrh; disordered digestion feverishness and thirstlessness after quinine."

Abdomen: Many troubles seem to manifest themselves in the abdomen by bloating, distension of the abdomen, flatulence, colicky pains, rumbling, fermentation of food, and from disorders of menstruation or diarrhea. Great sensitiveness, tumefaction, tenderness; whole abdomen, stomach and pelvic organs sensitive to touch. Bloating after eating, especially after fats and rich foods. Fullness of the veins; general venous stasis. It brings about especially a tumid fullness of the abdomen, such a stuffed feeling that she cannot breathe.

Women: In a woman about to menstruate, there is bloating of the abdomen, stuffed feeling, has to throw off her clothes, cannot wear stays, wants to get into a loose dress or, to go to bed so extremely puffed is she.

Associated with this abdominal tumefaction the face and lips become bloated and puffed, the eyes red, and the feet puffed so that she cannot wear her shoes. There is also a sensation of dragging down, a sense of great weakness, commonly related to the menstrual disturbances or uterine disorders.

The dragging down is recognized as prolapsus uteri. It is felt in the whole abdomen and is described as a funneling sensation, as if the parts would push out into the world, a dragging down. Oversensitiveness (of the abdomen; especially in the lower part of the abdomen. She cannot stand on her feet or walk around much, because of the weight and dragging down.

Labor-like pains in the uterus and back as if the menses would come on. It is not uncommon for the Pulsatilla patient to feel through the whole month as if she were about to menstruate. The abdominal and bowel symptoms are associated.

Cutting, flitting changing pains. Pains urging to stool. Griping, in the bowels associated with dysentery or diarrhoea; loose watery or green stools. A striking feature of the bowel symptoms is a loose, watery, green stool, continually changing; yellow, faecal, slimy.

In summer complaints, when Pulsatilla is the indicated remedy, there will be hardly two stools alike; continually changing. This is characteristic of Pulsatilla in general; the pains wander; complaints change by metastases; the patient is scarcely ever twice alike. Diarrhea alternating with constipation. Menstrual flow stops and starts, intermits and changes. In the Pulsatilla patient you never know what you will find next. Dysentery; dysenteric stools; scanty, slimy, bloody, green, watery stool with a little spurt; next stool might be diarrheic, with quite a copious discharge; thus you have diarrhoea and dysentery together.

Troublesome chronic constipation; stool large, hard and difficult to expel. It has (like Nux) frequent urging to stool without any, stool, or frequent urging with only a scanty stool; goes many times before can pass a stool, Nux and Pulsatilla.

Frequent unsuccessful urging in a chronic case is looked on as a keynote to Nux, but many remedies have it. Pulsatilla is one. The diarrhoea and bowel symptoms of Pulsatilla are worse, in the evening and during the night; that is, the stools are worse at night. The stomach, throat and mouth symptoms are worse in the morning. The mental symptoms are worse in the evening. The bowel and stool symptoms are aggravated by keeping perfectly still, and ameliorated by gentle motion.

There is much restlessness in Pulsatilla. Amelioration from motion in the cool open air. Feels stuffed up in a close room, and wants the windows open.

"Dysenteric stools of clear yellow, red or green slime; pain in the back, straining."

"Stools of deep green mucus; pain in the abdomen; no thirst."

You will remember the word green in Pulsatilla, as it relates extensively to the catarrhal discharges.

Most troublesome constipation with hemorrhoids; violent pains in the hemorrhoids, worse lying down, ameliorated from gentle motion, worse from the warmth of the bed, better moving about in the open air.

She becomes so nervous in a room while at rest that the pains seem intensified and she must move about.

Hemorrhoids:

"Hemorrhoids; painful protruding, blind, with itching and stitches in anus."

The aggravation from lying down in extremely painful hemorrhoids is contrasted with Ammonium carb. which has violently painful hemorrhoids relieved by lying flat on the back. In violently painful hemorrhoids, with intense burning, think of Arsenicum and Kali Carbonicum.

In those with sticking, tearing pains study Aesculus.

Looking over a number of years I have been forced to use in this cases a remedy not yet fully proven. In painful hemorrhoids, in a broken down constitution where the whole disease seems to culminate in the hemorrhoids; bleeding, protruding; a mere touch almost causes a convulsion; it causes her to scream out at the top of her voice; it is so painful that she feels that death would be a relief; she lies in bed, holding the nates far apart with her hands; after every stool she has three or four hours of extreme suffering. In these case look up the Paeony.

The hemorrhoids it cures look like the flowers of the plant, they are so inflamed, so red and bleeding; oozing; tender to touch; patient is so worn out with the pain. It has many times relieved the pain and cured these enormous hoemorrhoidal tumors. I have cured them after they. Had been operated on, and all sorts of violence done them, without relief. Do not go to this drug if you can find a remedy that covers all the patient. Many patients will not confess any other symptoms, and some of these will suffer so much from the hemorrhoids alone that you will really need this remedy.

Urine: frequent, scanty, with urging; wonderful tenesmus; extremely painful, bloody, burning, smarting urine; there is scarcely a drop collects in the bladder but it must be expelled. She cannot lie on the back without having a desire to urinate. She may go all night without urinating if she does not lie on the back, but the minute she turns on her back she is wakened by the desire to urinate and she feels that if she does not hurry she will pass it involuntarily. Involuntary urination when coughing and sneezing, or from a sudden shock or surprise, or from sudden joy, or from laughing, or from the noise of the slam of a door or a pistol shot. Pulsatilla has dribbling of urine, dribbles on the slightest provocation.

She must keep her mind. Continually on it, or she will lose her urine. As soon as she goes to sleep it flows away. Little, mild, gentle, florid, plethoric, warm-blooded girls, who kick the covers off at night and have nocturnal enuresis. Yellow, sallow, sickly girls who lose their urine in their first sleep call for Sepia. Losing the urine in the first sleep is looked upon as a strong symptom, but you can figure it out, and hence it is not so. All those cases that have to make an effort to hold the urine during the day lose in their first sleep; for then the mind is taken off it, and as soon as the mind is taken off it the urine dribbles.

Causticum and Sepia are remedies looked upon as curing involuntary urination during the first sleep, but I have cured it with many other remedies.

A man past middle age flooded the bed at night as soon as he went to sleep. The medicines which have this are limited and be had received them all. I found I must figure it out on another basis. I ascertained that when moving about at his work he had no difficulty in holding the urine but when he sat down he had to make an effort to control it. At the time this condition developed he had been in Atlantic City and had bathed much in the ocean. Here were the aggravation and amelioration of Rhus, and Rhus cured him. Few would think of Bryonia in urinary trouble. When he moves the urine dribbles, when he walks it flows. He is relieved only by keeping quiet. Bryonia is aggravated by motion; Rhus is relieved by motion.

Pulsatilla has relief from motion. A few remedies have relief from slow motion and of these Pulsatilla and Ferrum are the most striking. A few remedies are relieved by hurried motion; want to move fast. Such are Bromine and Arsenicum. The Arsenic child cannot be carried fast enough. The Pulsatilla baby is content with moderate motion. Any motion that heats up the Pulsatilla patient aggravates all the complaints. A wood sawyer working hard said his cough was relieved by moving about but when he became heated up from sawing he had to sit down and rest on account of the violent spasmodic cough that would come on.

Pulsatilla has complaints from exposure to rain; getting feet wet. Urinary troubles, worse when getting chilled (Dulcamara). Pulsatilla establishes a chronic, inveterate catarrh of the bladder. Copious mucous discharge, bloody discharge, especially after taking cold. Thick, ropy, purulent, green, offensive discharge.

Men: Sexual desire unusually strong.

"Long lasting morning erection."

"Sexual excesses resulting in headache, backache; limbs heavy."

"Burning and aching of the testicles, with or without swelling."

Orchitis; inflammation and swelling of the testicles from suppressed gonorrhea, from mumps, from catching cold, from, sitting on damp ground, or on a cold stone when perspiring. Gonorrhea suppressed by injections. "Cold" settles in the testicles. Pulsatilla is the most frequently indicated remedy in gonorrhoea. in which the discharge is thick yellow or thick yellow and green, in those who are sensitive to heat, ameliorated walking in the open air. But also in persons with no other symptoms, and the gonorrheal discharge is thick yellow or green; no symptoms contra-indicating it.

Troublesome lingering discharges; an old gleet rouses into a thick yellow discharge, when be takes cold or after coition. Frequent tenesmus; chordee; urging to urinate; burning urination and yellow discharge.

Tumefaction about the penis. Foreskin dropsical. (Nitric ac., Fluor. ac., Cann. sat.). Pulsatilla is useful in cases of suppressed gonorrhea, with complaints following. Inflammation of the prostate. In old sinners with enlarged prostate, hard, flat, packed faeces, must always use a catheter; especially when the trouble has been brought on by sexual abuses, sexual excesses, vices. Pain in the testicles; tearing in the swollen testicles. Pain along the cord like cutting of knives; lacerating, tearing.

Women: Exaggerated sexual desire; nymphomania; wild, beside herself with sexual thoughts; uncontrollable sexual desire. Inflammation of ovaries and uterus. Suppression of menses from getting feet wet. Menses too late, scanty.

Face pale, yellow, sallow, or green like a chlorotic patient. It overcomes the tendency to miscarriage, false conception, moles, etc., and stops the growth of fibroids, other symptoms agreeing. In pregnancy and during confinement many symptoms call for Pulsatilla.

Most often called for when the patient is not irritable and the pains are very feeble, lasting for several days, and doing nothing; irregular, flitting, changeable pains, now up the back, now down the limbs; a prolonged first stage or prolonged preparatory symptoms. Chamomilla is more suitable if the woman is extremely irritable. But in a mild, gentle, mental state, when the pains are irregular, the os dilated and the contractions have let up, the pains too short, Pulsatilla will terminate that labor in a short time. The next pain after the dose will be a good one. You very often see in these cases that the outside parts are relaxed and the conditions are such that everything ought to go on well, but there is inaction. For weak pains Pulsatilla stands high.

Violent menstrual colic, causing her to bend double; soreness in the region of the uterus and ovaries; distended abdomen; throws the covers off; wants the windows open; tearful; weeps without a cause. Suppression of the menstrual flow from getting feet wet. Flow slow in being established and then scarcely more than a leucorrhea.

Menstruation that has been painful since puberty in plethoric girls. I have seen Pulsatilla cure a great many girls of sixteen to eighteen years old. The mother comes to me saying her daughter has suffered since her first menses; she went in swimming, or got her feet wet, and has suffered since. The doctor says the parts 'are undeveloped and she must be operated on. Pulsatilla has established a normal flow in a few months. Now I will give you a contrast in another remedy. Scrawny girls who are sensitive to cold, have also taken a bath at the time the first menses should appear, or have got the feet wet, and the flow is partially suppressed, or has come on with an inflammation; a state of undevelopment is established, a stenosis; horrible menstrual colic; bearing down pains, as if everything would escape into the world, doubling the patient up; ameliorated by heat and aggravated by cold. Calc. phos. is the remedy. "In girls of mild disposition, when puberty is unduly delayed, or menstrual function is defectively or irregularly performed; they are pale and languid, complain of headache, chilliness and lassitude."

To develop these young girls Pulsatilla is a great remedy. Most troublesome cases of prolapsus. It competes with Sepia, Belladonna, Natrum mur., Nux vomica and Secale; all of these are remedies with great relaxation, bearing down; some have cured even procidentia.

Pulsatilla cures many cases of gonorrhoea in females. I think it is most commonly indicated. A striking feature is, when the menstrual flow is present there is milk in the breasts.

In girls at puberty - milk in the breasts; a premature establishment of milk. In nonpregnant women, milk in the breasts. (Cyclamen and Mercurius.)

Chest: The chest, respiratory organs, and cough furnish some most troublesome symptoms. Bronchitis; pneumonia. Dry, teasing cough and dyspnoea; wants the windows open, aggravated lying down. Cough gagging and choking. Copious expectoration in the morning, of thick yellowgreen mucus. Dry, teasing cough at night, worse lying down, Chronic loose cough after measles. Whooping cough.

In the larynx we have many symptoms; constriction; tickling causing cough. Dry, teasing cough, worse lying and in a warm room. Cough worse at night. Bronchitis with loose morning and dry, evening cough.

Dyspnoea; oppression from walking fast or becoming overheated after eating; stopping up nose; after emotions. Spasmodic contraction of larynx. Tightness of chest; dyspnoea when lying on left edge; suffocation in the evening and during the night.

Asthma of children from suppressed rash or in women from suppressed menses. Loud rattling in the chest when lying. Chronic loose cough after measles. Expectoration of copious, thick, yellowgreen, or bloody mucus; salty; offensive. Chronic catarrh of chest. Sensation of fullness in the chest in the evening with pulsation preventing sleep.

Palpitation from lying on the left side. Soreness in the walls of the chest. Pain in the chest sometimes relieved by lying on the opposite side; dryness and rawness in the chest. Wandering tearing pains in the chest; cutting pains in pleurisy; violent beat in the chest. Haemorrhage of the lungs, dark blood. Dry cough in the evening, loose in the morning.

Hemorrhage with suppressed menses or instead of the menses. Pulsatilla is very useful in catarrhal phthisis in chlorotic girls.

Back: In curvature of the spine Puls. is of great value.

Pain in the back, lumbar and sacral regions; wandering pains; spinal irritation after sexual excesses. Rheumatic pains in the spine and limbs, worse during rest and better from slow motion. Pain in small of back as if sprained; sensation of cold water poured down back. All the limbs are painful; drawing, tearing pains in the limbs, better from motion and after motion; worse from a warm room and better from cold applications. Swelling of the veins in the arms and hands. Varicose veins of the limbs like Fl. ac. Rheumatism of joints; pain in joints as if dislocated. Sciatica worse in the evening and better from slowly moving about. Drawing and tension of muscles in lower limbs in the evening in bed. Tearing, jerking pains in the limbs, changing place. Burning in the veins. Purple swelling with violent itching of the feet as if they had been frozen. Feet burn, and he must put them out of bed. Soles bum and are bruised when walking.

Marked restlessness and twitching of the limbs and feet; numbness of the limb, lain on; wandering pains in all the limbs.

Sleeps on the back with hands over head. Cannot sleep on the left side as it increases the palpitation and suffocation. Confused, frightful, anxious dreams. Late falling asleep; sleeplessness on account of flushes of heat. Pulsatilla cures intermittent fever, coming on from; disordered stomach. Chill morning and evening daily. The chill begins in the bands and feet; pains in the limbs during the chill; one sided coldness with numb feeling; fever one sided.

Thirst before the chill and seldom during the heat; heat with distended veins; sweat profuse all over or only on one side of the body. Vomiting of mucus during the chill.