Cimicifuga

Lecture

This remedy has been only eagerly proved, yet there are a few useful points in it. From its proving we can perceive that it is similar to diseased states in the human family, and especially in women, namely, hysterical and rheumatic conditions. The patient is always chilly, easily affected by cold, sensitive to cold and damp weather, which rouses the rheumatic state and develops a state of rheumatism; not only in the muscles and joints all over the body, but also along the course of nerves. In the general nervous disturbance there is a lack of will balance, or great disturbance in the voluntary system, which is the underlying feature of hysteria, the symptoms are intermingled with rheumatism. With the pains we have soreness all over the body. Trembling, numbness, jerking of muscles. Inability to exercise the will over the muscles of the body, turmoil in the voluntary system, with stiffness.

Tendency to take cold and thereby she takes on sensitiveness in the glands and larger organs, such as the liver and uterus. Complaints in these organs come on from cold damp weather (Dulcamara) and from being chilled. The patient is sensitive to cold in all parts except the head, and is aggravated from becoming cold both in parts of the body and in general. The headaches, however, are better in the open air and from cold, which is an exception and a particular, for the general feature is aggravation from cold.

There is a terrible mental state that alternates with physical states. It is an overwhelming sadness or gloominess, she is bowed down with sorrow. Sits and mopes in great sadness, like Psorinum and Puls- Ulla. This may pass off instantly, or be brought on and aggravated from motion, from fear, from excitement, from taking cold. Very commonly there is muscular soreness, a bruised feeling all over, with! drawing and jerking. This will let up very suddenly and leave a nervous, hysterical girl in a state of sadness, and she will sit and say nothing. When questioned perhaps she will break into tears or cx press in various ways the overwhelming sadness. With the headache there is marked sadness. Changeable moods. The physical and the mental are all the time changing. Other symptoms alternate and change. The jerking has made physicians see the resemblance to chorea in these hystero-rheumatic constitutions. The rheumatisms will change in a day into chorea, and again the choreic movements will keep on with the soreness throughout the muscles of the body. The jerking and soreness and numbness often keep on together.

There are certain features about the chorea that should be noted. Jerking of the muscles when in a state of emotion or from becoming chilled. If any part of the body is pressed upon jerking of the muscles of that part will take place. One of these nervous, rheumatic, hysterical subjects may not have chorea constantly, but as soon as she retires at night the whole of the side lain on will commence to jerk and prevent her from going to sleep. If she turns on the back the muscles of the back and shoulders will jerk and prevent sleep. She turns over on the other side, but after a little while the muscles pressed on commence to jerk. All this time she has become so restless and nervous that she is driven to distraction. The mind is full of all sorts of imaginations, and the body is full of all sorts of uneasiness, because she can find no place to rest upon. Sometimes the muscles are so sore that they cannot be lain upon for any length of time ; sometimes It 18 a numbness, sometimes a jerking. These things are queer, but they belong to the patient, affecting not one part, but the whole economy.

Full of fear, anguish and restlessness. Fear of death, excitement, suspicious, Will not even take the medicine because there U something wrong about it.’’ It has a mania such as occurs in nervous, hysterical women, and it has cured puerperal mania. Puerperal mania from taking cold during or soon after confinement. The remedy belongs especially to women, because its symptoms are so commonly associated with the affections of women. Mental states following the disappearance of rheumatism is a strong feature. The rheumatism gets better, but the mental state becomes worse. Sometimes the rheumatism disappears in short order and the mind is not disturbed, but then it is because a diarrhoea has come on, with great soreness and aching in the bowels, or because a flow from the uterus has given relief. There must be some relief or a disturbance will take place like Abrotanum. Some flow must be established, and hence the menstrual flow or diarrhoea gives relief ; otherwise the mind takes on trouble, the patient becomes gloomy, or has a low form of mental excitement. One of the symptoms is quite descriptive of this sadness I have referred to : ‘Sensation as if a black cloud had settled all over her,” while at the same time it weighed like '‘lead upon the head.” This is entirely figurative. It can all be expressed in the word “sadness”. We will find “melancholy,” “gloominess,” “low spirited,” etc., running all through out text, but the word “sadness” is just as broad as any of them.

The headaches are rheumatic. “Sore, bruised feeling all over the head. Bruised sensation in the occiput. Sore, bruised feeling in the top of the head, as if the , top of the head would fly off.” “As if cold air was blowing upon the brain.’' Yet most of these headaches are better by being in the cold air. “Headache brought on from catching cold, from the weather changes, cold, damp weather.” There are many headaches. Pressing headache. Many of the headaches are intense, and described as if a bolt were extending down into the back of the neck. Soreness in the back of the neck. Pain in the back of the neck. Hysterical girls ; they have much pain in the back of the neck. With the headache the eyeballs are very sore, “painful to turn in any direction.” “Pain in the eyes, bruised pain in the head.”

“Soreness in the abdomen ; sore and bruised. Alternate diarrhoea and constipation. Alternation of diarrhoea and physical complaints.”

We pass now to the female genitalia, which form a center for a great deal of trouble in the remedy. A routine saying about Actaea is that it makes confinement easy. That is not a legitimate saying concerning any remedy, and such expressions encourage routine practice. It is true that when this remedy has been given to pregnant women in accordance with its symptoms it has proved capable of making confinement easy. But the way it has been given has been the (routine practice of giving it in the tincture or in the 2d or 3d, until the patient was under its influence even when it was not indicated, as it was not similar to the case. But the homoeopathic physician never practices in this way. A remedy fits a general condition when the symptoms of that general condition are found in the remedy. Remember that it doe.s so because all the symptoms agree.

“Pain in the uterine region, darting from side to side. Bearing down and pressing out.” These bearing down sensations, taken with all the other states that relate to the patient in general, show that it is a very useful remedy in prolapsus of the uterus. It has the relaxation of the parts. Do not suppose that our remedies are not sufficient to cure these conditions, when the symptoms agree. It is true that remedies will cure prolapsus when the symptoms agree, and at no other time. If it fits the patient in general, these bearing down sensations will go away, the patient will be made comfortable, and an examination will finally show that the parts are in normal condition. You cannot prescribe for the prolapsus ; you must prescribe for the woman. You cannot prescribe for one symptom, because there are probably fifty remedies that have that symptom.

Thcie ire menstrual disorders in these hysterical rheumatic constitutions. Irregularity of the menstrual flow. It may be copious, suppressed or scanty. Severe pain all through the flow. The more the flow the greater the pain. That is very peculiar. Generally the flow will relieve pain, but with this remedy the pain is during the flow. Generally the most severe and most painful attack is at the beginning of the flow, and with some women again just after the flow has ceased, Each woman is a law unto herself. In this remedy the sufferings are during the menstrual flow as a rule. The most severe mental symptoms, the most severe rheumatic symptoms, the most extreme jerking flot Tu?in! m sleeplessness are during the menstrual flow. During menses, epileptic spasms. All sorts of sufferings in the nerves. Soreness along the course of the nerves, soreness in Ae muscles or joints during the flow. Increase of mental symptoms. Cold and chilly, must be wrapped up. “Rheumatism. Dysmenorrhœa ” Soreness m the uterus and ovarian region. Lame, build feeling all over ; painful menstruation,” and some one has named that rhematic dysmenorrhoea, not a bad name. rheumatic in cv""? pregnancy. It cures all sorts of conditions m this kind of constitution, these nervous, rheumatic with jerking in the muscles. So markedly do her trm ff a with ad, o,h., ha. atemahon “path. will commonly find that all the rest of her tm 1 1 u and that now „a„«a ha, com. on. In all A. y.t, S'h Tn

sev... have .™p„,ad,y .t;Tan“i about like Pulsatilla, But the symptoms have to be taken collectively to get at the image of the patient. A woman will come to you with one group of symptoms today and may come back to you with an entirely different group in a couple of weeks. These are very troublesome cases to prescribe for, and you have sometimes to take the symptoms a dozen times and put them all together as if she had felt them all in one day, and so make your prescription. A hysterical patient is difficult to manage because of this changing of symptoms, and also because she has a tendency to deceive the doctor.

"'Shivering in the first stage of labor. Hysterical manifestations through labor.” Pains have all ceased or are irregular, so that they do not good. No dilatation has taken place. But when the regular pains come on we have some important symptoms. A pain comes on and it seems to be about to finish satisfactorily ; it has been regular and prolonged until about two-thirds through, and all at once she screams out and grasps her hip— the pain has left the uterus and gone to the hip, causing a cramp in the hip, and she has to be rubbed and turned over. This medicine will regulate the pains, and when the next pain comes it will hold on to the end. So impressionable is this woman during confinement that if she is subjected to any emotion — such as having an emotional story told in the room — or if anything excitable occurs, the pain will stop. If she has passed through the labor and the lochia has been established, from such a cause the lochia will stop, as if she had taken cold, ; and she will have cramps and troublesome after-pains, the milk will be suppressed, she will feel sore and bruised all over, and have fever. This remedy should be compared with Caulophyllum, which has the following symptoms: Weakness in the reproductive system of the woman. From weakness she is sterile, or she aborts in the early months of gestation. During parturition the contractions of the uterus are too feeble to expel the contents, and they are only tormenting. Labor-like pains during menstruation with drawing pains in the thighs and legs, and even the feet and toes. Uterine haemorrhage from inertia of the uterus. Relaxation of muscles and ligaments. Heaviness, and even prolapsus. Subinvolution. Excoriating leucorrhoea. Menses too soon or too late. She is sensitive to cold and wants warm clothing — quite unlike Pulsatilla, She is hysterical, like Ignatia, She is fretful and apprehensive. She is rheumatic, like Actaea, only the small joints are most likely to be affected. Later she suffers from after-pains, and they are felt in the inguinal region. Rheumatic stiffness of the back and very sensitive spine. She is sleepless, restless and withal very excitable. This remedy has cured chorea at puberty when menstruation was late.

You need not be surprised that such an emotional subject has a fluttering, quick pulse, and irregular action of the heart, but many of the most marked hysterical features are present without any disturbances whatever in the action of the heart. “A feeling in the region of the heart as if the heart were sore, and as if it were enlarged.”

"Back of head and neck sore.” The head is drawn back from contraction of the muscles at the nape. Violent aching down the back. Rheumatism in the back. Impossible to lie upon the back because of the contraction of the muscles of the back. Impossible to lie upon the side of the body because of the contraction and jerking of the muscles. “Numbness of the limbs. Trembling. Soreness.”

The symptoms of the nerves are simply a reiteration of what I have said. “Hysterical spasms. Convulsions. Trembling of the legs ; hardly able to walk.” The numbness is such as is associated with paralysis. Paralytic weakness.

The best effects have resulted from the 30th, 200th, loooth and still higher potencies, and from the use of medicine in single doses.

It is similar in some of its conditions to the Blue Cohosh. Compare it with Puls., Sepia, Natr. mur.. Lit. t., Caulophyllum and ign. aesculus HIPPOCASTANUM

A peculiar kind of plethora is found running through this remedy, a vascular fulness which affects the extremities and the whole body, and there are symptoms showing that the brain is similarly affected.

The conditions of *æsculus are worse during sleep, hence symptoms are observed on waking. He wakes up with confusion of mind, looks all around the room in confusion, bewildered, does not know the people, wonders where he is and what is the meaning of the things he sees. It is especially useful in children that rouse up in sleep frightened and in confusion, like Lycopodium. The remedy produces great sadness, irritability, loss of memory and aversion to work. There are times when there is a sense of bodily congestion, fulness of the veins, and then these symptoms are most marked. It is a general venous stasis, and is sometimes worse in sleep, worse from lying, better from bodily exertion. The symptoms pass away after considerable exertion moving about, doing something, keeping busy relieves. You will find it useful in persons who suffer from palpitation when the pulsation extends to the extremities and the throbbing of the heart in sleep can be heard ; an audible palpitation.

Now, as the mental symptoms are the most important in a proving, so are the mental symptoms in sickness the most important. Hahnemann directs us to pay most attention to the symptoms of the mind, because the symptoms of the mind constitute the man himself. The highest and innermost symptoms are the most important, and these are the mind symptoms. aesculus has not been brought out in the finest detail, but we have the key to it. Extreme irritability is the very general state from which ramify a great many mental symptoms. Irritability and mental depression run through a great many remedies, and form the centre around which revolve all the mental symptoms in some cases. The reason that these are more interior than some other symptoms of the mind is that these relate to the affections themselves. The mental symptoms can be classified in a remedy. The things that relate to the memory are not so important as the things that relate to the intelligence, and the things that relate to the intelligence are not so important as the things that relate to the affections or desires and aversions. We see in a state of irritability that the patient is not irritable while doing the things that he desires to do ; if he wants to be talked to, for instance, you do not discover his irritability while talking to him. You never discover he is irritable if you do the things he wants you to do. But just as soon as you do something he does not want, this irritability or disturbance of the will is brought on, and this is the very innermost of the man's state. That which he wishes belongs to that which he wills, and the tilings that relate to what he wills are the most important things in every proving. You may say that an individual is sad, but he is sad because he lacks something that he wants ; he desires something which he has not and becomes sad for it ; sadness may go on to such an extent that the mind is in confusion.

Confusion of mind and vertigo. Make this distinction, vertigo is not a confusion of the intelligence. You have only to meditate upon it a moment and you will see that it is not. Confusion of the mind is a disturbance of the intellect, not a disturbance of the sensorium ; you will make a distinction between staggering when walking and a period of disturbance of the mind, with inability to think clearly. Vertigo is a sensation of rolling, and belongs to the sensorium. A great mistake has been made in some of our repertories, in that confusions of mind are placed with vertigo under sensorium. These things must be thought out carefully, so that we are clear in our own minds as to, what symptoms mean when they are given to us by patients. A patient may state that when walking in the street he is dizzy, or that it appears as though everything interiorly were turning around, yet he may be perfectly able to add up a column of figures ; his mind may be clear. If we ourselves are perfectly clear as to the meaning of these expressions, we will commonly glean the meaning of the patient. It is important to record the language of the patient, yet often a patient will say something which you can see he does not mean at all, and it then becomes necessary to put in a parenthesis what he really means. For instance, a patient says: 'T have such a pain in my chest,'a with the hand on the abdomen, or a woman when menstruating will say the pain is in the stomach when you know it is in the uterus. Patients must be questioned oftentimes as to their statements, or requested to place the hand upon the painful part. In the same way, therefore, patients talk about dizziness when they are not dizzy at all, but feel a confusion of mind, or they speak of confusion of mind when they mean that they stagger in the street

It is in the nature of this remedy to have flying pains all over the body, like Pulsatilla and Kali carb.', flitting, sharp, shooting, tearing pains, flying from one part to another ; they seem at times to be scarcely more than skin deep. Sometimes they fly along the course of the nerves.

This remedy is full of headache. It has also dull aching pain, when it seems that the brain would he pressed out. But especially are these pains felt in the back of the head, as if the head would be crushed; hard aching pains, violent aching pains, fulness of the brain. “Dull frontal headache, from right to left, with constrictive feeling of skin of forehead.” Fulness of the head, with dull, heavy pains, aching in the forehead ; pain over the right eye. “Neuralgic pains in the right supraorbital region.” “Shooting in left parietal bone, later in right.” Formication of the scalp. If you examine the skin you will find formication, tickling and shooting and itching all over the body, so what there is in the scalp is only what belongs to the remedy in all parts.

.<5æsculus is a wonderful eye remedy, especially when the eyes have “haemorrhoids.” Does that convey any idea to you ? By that I mean particularly enlarged blood vessels. Great redness of the eyes, with lachrymation. burning eyeballs and vascular appearance. This increased determination of blood is more or less painful ; the eyeballs feel sore and ache ; sharp, shooting pains in eyes. In almost every rubric of .æsculus we shall find stitching and shooting : little twinges ; wandering pains with fulness ; almost every kind of disturbance will intensify the fulness. Fulness of the hands and feet, not the fulness that pits upon pressure, that we call oedema, but a tenseness. Medicines having much trouble with the veins are often disturbed by hot bathing, weakness after a hot bath, weakness in warm weather, aversion to heat and desire for cold. It is the state of Pulsatilla. The Pulsatilla veins contract in cold weather, and the shrivelling up makes the patient feel better, but the veins fill and become engorged in the warm air and after a hot bath. A tepid bath sometimes makes a Pulsatilla patient feel better, but a Turkish bath is generally distressing. Many of the complaints of Aesculus are of this sort ; .æsculus often feels better in cold air. The symptoms of aesculus are often brought out by temperature, especially the little stinging pains. It is characteristic of these superficial pains that they are nearly always ameliorated by heat, while the deeper affections are oftentimes ameliorated from cold. Now, in Pulsatilla, the stinging pains of the scalp and those over the body, here and there, are often ameliorated by the local application of heat, while the patient himself wants to be in the cold ; in the same way aesculus stinging pains are better from heat, while the patient is often better from cold, although at times he is aggravated from cold, damp weather in rheumatic and venous conditions. Again, in Secale, we see that the little sharp pains that follow the course of the nerves are better from heat, but the patient himself wants to be in the cold air, or to be uncovered, except the spot of pain, which he wants kept warm. We notice the same thing running through Camphor; during the twinges of pain he wants the windows closed and wants hot applications ; but as soon as the pain is over he wants the windows up and desires to be uncovered so that he can breathe. These are general things, things that are to be observed in analyzing symptoms.

.æsculus then is a venous remedy, engorged and full, sometimes to bursting. Now, there is another feature 1 want to bring out. You will notice where congestion takes place that it is purple or blue in color. This remedy produces inflammation of the throat, the characteristic being that it is very dark. It has the tendency to produce varicose veins and ulceration, and round about these we have marked duskiness. Aesculus cures varicose leg ulcers with a purplish areola. When we study the haemorrhoidal state we sec the tumor is purple, looking almost as if it would slough. The remedy is not active in its inflammatory state, it is sluggish and passive. Certain remedies produce a slight inflammation With a high degree of redness, everything is violent and rapid, but in this medicine things are slow ; the activities are reduced, the heart is laboring and the veins are congested.

“Eructations: sour, greasy, bitter.” “Desire to vomit.” "'Heartburn and gulping up of food after eating,'' It has a great disturbance of digestion, and we can see by these symptoms that we must class it with Phosphorus and Ferrum, As soon as the patient has swallowed the food, or a little while after, it becomes sour and he eructates it, until after a while he has emptied the stomach of its contents. Such is the state of Phosphorus, Ferrum, Arsenicum, .AEsculus and a few other medicines, .æsculus has also a state of congestion and ulceration of the stomach. “Constant distress and burning in the stomach, inclination to vomit.” Such a state as this might be present in ulceration of the stomach.

The abdomen is full of trouble. If w'c read the symptoms of the right hypochondrium, of the abdomen and of the rectum, we shall see from the study of these that there must be a marked portal stasis. Digestion is slow, the bowels are constipated and there is protrusion of the rectum when at stool. It has most troublesome hemorrhoids with fullness of the right hypochondrium. The liver is full of suffering. After eating there is distress in the bowels and rectum. Sticking, jagging, burning pains, as if the rectum were full of sticks. Great suffering with blind haemorrhoids. The haemorrhoidal veins are all distended and ulcerate. The stool becomes jammed into the rectum, against these distended veins, and then ulceration takes place with bleeding and great suffering. This remedy is often supposed to be suitable to haemorrhoids that do not bleed, but it cures bleeding piles also. We find in the text over two pages devoted to the symptoms of the rectum. Great soreness ; much pain ; urging to stool ; dark stool followed by white one, showing the liver engorgement. Chronic constipation.

The back is the seat of much trouble, especially low down in the back, through the sacrum and hips ; although there is also aching all along the back and pain in the back of the neck. It is a very common thing for patients suffering from haemorrhoids to have pain in the back of the neck and base of the brain, basilar headaches, and when these haemorrhoidal patients undertake to walk they have pain and aching across the sacrum into the hips. This pam through the sacrum and into the hips W'hen walking, is a striking feature of Æsculus, so striking that you may expect it to be present even when there are no haemorrhoids.

Constant dull backache ; walking is almost impossible ; scarcely able to rise or walk after sitting. You will see one suffering from the aesculus backache, on attempting to rise from sitting, make many painful efforts before be finally succeeds. This is found in Sulphur, Petroleum and is also cured by Agaricus.

ilsculus is indicated oftentimes in the troubles of women, with great dragging pain in the pelvis. Many a time has .æsculus cured the dragging-down pain of the pelvis with copious leucorrhoea and press ing pain in the hips when walking. The woman feels that the uterus is engorged. She says that the lower part of the abdomen feels full, both before and during menstruation. There is much suffering at this time with pains in the hips. '‘Uterine soreness, with throbbing in the hypogastrium.” “Old cases of leucorrhoea, discharge of a dark yellow color, thick and sticky.” “Leucorrhoea, with lameness in the back across sacroiliac articulations* During pregnancy there are many complaints, with soreness and fulness and uneasy consciousness of the uterus and pain across the back when walking.

-æsculus is full of gouty sufferings; gout in all the joints, gouty rheumatic affections, neuralgic affections. Especially in this rheumatic tendency found from the elbows to the hands, in the forearm and hands. Rending, tearing pains, flying hither and thither without any particular order, relieved by heat. Varicose veins of the thighs and legs have been cured by Aesculus (Fluoric acid). This varicose tendency in the body we have already seen is a striking feature of .æsculus. After the sore throat has passed away, engorged veins are left, which -/Esculus sometimes cures. After eye troubles have been cured, varicose veins remain in the eye. With rheumatic complaints there are varicose veins. It is one of the most frequently indicated remedies in the haemorrhoidal constitution, as it used to be called. THUSA CYNAPIUM

Before Aethusa was known a certain class of cases of cholera infantum, and vomiting and diarrhoea in children, all resulted fatally, because there was no remedy that looked like such serious cases. Death is stamped on the face from the beginning, and if there are any remedies in the book that save life this is one of them. It applies to the cases that come on very suddenly in hot weather in infancy, with extreme prostration. The mother does not suspect the child is sick until she takes it from the crib ; only a few hours before it was well ; but when cholera infantum is prevalent in hot weather, this little one fills its stomach with milk and almost before it has had time to coagulate or form into curds the milk comes up partly in curds and partly liquid, and accompanying the vomiting there is a thin, yellow greenish, slimy stool. The child has the appearance as if it were dying, pale hippocratic face, there is a whitish-blue pallor around the lips, the eyes are sunken and there hi a sunken condition around the nose. The mother is astonished and sends for the doctor hurriedly. The child sinks into an exhausted sleep. It wakes up and again fills the stomach with milk which comes up again in a few minutes, partly in curd and partly liquid, and again there is the awful exhaustion, deathly appearance and prolonged sleep. Without thusa, in two or three days the undertaker gets that child. That is pretty nearly the whole story of aethusa.

It has delirium, it has excitement, it has mental disturbances of various kinds, but they are acute and accompany the brain troubles. A certain class of infants come down sick in the hot weather, in the hot nights, and they get brain trouble, and from that time the stomach quits business, the bowels become relaxed, and everything put into the stomach either comes up or goes right through. This occurs especially in those infants that have been fed as the ordinary everyday mother feeds her baby, and how is that ? Every time it cries she puts it to the breast or feeds it. Well, now ; let us think a bit. Every doctor ought to think a little, once in a while. Now meditate a trifle as to whether that is a wise or foolish thing to do. It takes about two hours or two hours and a half for the ordinary baby’s stomach to transact good wholesome business in digesting the milk taken, and it ought to have a rest of half an hour or so, and when we get up to three hours and the baby cries then it is probably hungry and will be glad to take some more and digest it. Any shorter interval of feeding than that is bad practice. It would be just the same thing if the child should take half a teacupful of milk and let it partly digest, and in a little while take a little more, and then lair add a little more. It commences to spit up its food and it is sour, and the very first spell of hot weather that comes brings on head trouble. Only the toughest children will stand this bad method. I have watched these children and seen them stand it until the summer. The doctor must put his foot down, and put it down violently, and make them see he means it. The old woman comes in and says: “That doctor does not know anything’’ and the baby must be fed. Now Aethusa suits improperly fed babies. It is at the head of the list of medicines for that condition ; that is, when digestion has absolutely ceased from brain trouble. So far as busy doctors have discovered the call for this remedy, it has been mostly among babies, but adults sometimes take on an .a5thusa state, when digestion has absolutely ceased from brain trouble and from excitement. It has cured dyspepsia from constant feeding, in those nibblers, those hungry fellows who are always eating, always nibbling, always taking crackers in their pockets until there comes a time when the stomach ceases to act. It also suits cases of indigestion from head troubles, with hot head, vomiting, exhaustion, sweat and long sleep.

iEthusa has convulsions in children. Sometimes the brain trouble does not affect the stomach, but the child goes into convulsions, with clammy hands, deathly countenance, and the sweat, exhaustion and sleep. “Convulsions, great weakness and prostration, with sleepiness. Dosing of the child after vomiting and after stool, with convulsions.”

In the .Ilthusa patient there is much in the face and aspect to indicate a remedy ; so much can be seen and comes within the observation, and so little questioning is necessary, that a sort of snap-shot prescribing can be done, but it is not to be recommended. A busy physician, one who really and truly studies his Materia Medica, and has learned the principles, will in time do a great deal of what seems to be snap-shot prescribing, but he really does not do so, because he puts together many things that outsiders would not think of. ./AEthusa then shows itself upon the surface, whereas in many remedies there is nothing seen upon the surface, because they manifest themselves in inner or deeper sensations. Let me lay a case before you to illustrate this. For instance, take a robust looking fellow, who declares himself fairly well, out to lunch with you. You have noticed for some time that his nose is all the time peeling off ; at once there is a star. He never talks about his health. Pretty soon, while lunching, the door slams and he jumps. That is the second point. Then he tells you how much he cats, how well it affects him, how good he feels after eating, and you have noticed yourself that he cats a good deal You have not said one word about his health to him. You have not asked him to tell you any symptoms. Finally you shove the pitcher of milk over to him, and he says, “Oh, I can’t drink milk ; if I take milk it gives me diarrhoea ; I never think of taking it.” Who could not prescribe for that fellow without taking him into the office ? Who would think of anything but Natrum carb, for such a case ? Sometimes you can find out the whole story by getting a stubborn patient to go and dine with you.