Homeopathic Materia Medica

Lectures on Homoeopathic Materia Medica, James Tyler Kent

Coldness: The Hepar patient is chilly. He is sensitive to the cold and wants an unusual amount of clothing when in cold air. He wants the sleeping room very warm and can endure much heat in the room, many degrees warmer than a healthy person ordinarily desires, He has no endurance in the cold and all his complaints are made worse in the cold. If he becomes cold in sleep his complaints come on or if he is out in the cold, dry wind, complaints come on; inflammatory and rheumatic complaints appear.

The exposure of hand or foot at night in bed brings on symptoms. He wants the covers drawn close about the neck when in bed. This patient is also oversensitive to impressions, to surroundings and to pain. What with an ordinary person would only be an ache or disagreeable sensation becomes with Hepar an intense suffering.

Pains: But the pains of Hepar may be very severe, very sharp. Inflamed spots, eruptions, boils or suppurations are full of sharp pains. This is so intense that it is described at times, as a sticking and jagging like sharp sticks.

The pains in ulcers are often felt like sticks; intense and sharp as if sticks were jagging the ulcer. This sensation is often expressed by the patient suffering from sore throat. Lip feels as if he had swallowed a fish bone, or stick. This is in keeping with the general character, because it is present everywhere, in inflammations, ulcers, pustules, boils and eruptions; all seem to have sticks in them or some thing jagging.

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

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

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

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

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

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

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

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

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

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

The catarrhal state: is general.

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

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

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

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

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

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

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

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

Sensitive children that are exposed during the day in a cold, dry wind, or cold air, come down next morning with a violent attack of croup. The Hepar croup is worse in the morning and in the evening; evening until midnight. Sometimes cases that at first call for Aconite run into Hepar.

The Acon. croup comes on with great violence, worse in the evening before midnight. The child wakes up from its first sleep with a hoarse, barking croup. A dose of Aconit may prove entirely sufficient; or it may be only a palliative.

The child goes to sleep and along towards morning, or at least sometime after midnight, there is another attack, which shows that Acon. was not sufficient. Such a case will be controlled by Hepar.

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

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

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

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

Ears: It has catarrhal affections of the ear.

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

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

Eyes: Hepar sometimes is bad on the oculist.

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

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

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

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

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

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

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

This horribly offensive odor that is so permeating is often cured by Kali phos. It has really one of the most penetrating of odors, so much so that when a woman suffers from this leucorrhoea the odor can be detected when she enters the room.

A very important sphere for Hepar is after mercurialisation. Many old people are walking the street at the present day who have been the victims of Calomel, who have been salivated, who have taken blue pill for recurrent bilious spells, to "tap the liver.," until finally they get into a state of chilliness felt, as it were, in the bone.

They sweat much about the head, they ache in the bones, and every change of weather to cold, and every cold, damp spell affects them. They, are like barometers. Hepar is the remedy for that state.

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

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

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

This is the time that Hepar becomes an intercurrent remedy. Sil. follows well after Hepar, and Hepar follows well after Merc., and thus becomes an intercurrent in that series.

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

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

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

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

Throat: As we go into the syphilitic affections that lead into the throat, we find ulcers of the soft palate which eat away the uvula, small ulcers which finally unite and destroy the soft palate and then commence to work upon the osseous portion of the roof of the mouth.

The odor that comes from that mouth when it is opened to show the throat is extremely offensive; very often like spoiled cheese. The medicines that are especially related, or especially useful in this form of ulceration in old syphilitics, will be Kali bi., Lach., Merc. cor., Merc. and Hepar, but in those syphilitic cases that have been mercurialized Hepar and Nitric acid should be thought of.

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

You think of the two together. Both have sensation of a fish bone or stick in the throat.

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

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

Hepar has also sycotic warts. It is useful in old cases of gleet; also when there is a sensation of a splinter in the urethra. In strictures and constrictions of inflammatory character during the inflammation there is a tendency to ulcerate, and with this the sensation of a stick is felt.

Arg. nit., Nit. ac. and Hepar run close together for this kind of inflammation, and will cure the inflammatory stricture before it becomes a complete and permanent fibrinous stricture.

It is only very rarely that you will be able with your medicines to cure a stricture after it has taken on permanency, after it is many years old, but as long as the inflammation keeps up there is hope.

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

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

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

Hepar if indicated by the general symptoms of the patient hastens the suppuration and heals up the finger, for it has all such things. Silica is another remedy capable of establishing inflammation and suppuration and removes little foreign bodies that cannot be located.

Of course it is understood that if the physician knows the location of a splinter, he will take such steps as are necessary to remove it, and not wait for the action of a remedy. But at times a needle point breaks off against the bone of the finger of a seamstress, or small portions of the needle may exist where they cannot be found without an immense amount of slashing which the patient refuses. Hepar or Silica will remove it. A little abscess will form and the little mite will be discharged.

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

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

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

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

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

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

Many excellent homoeopathic physicians have said to me,

"I do not agree with you as to the danger of Sulphur in phthisical cases. I have cured cases of phthisis with Sulphur."

So have I many of them. But I did not refer to curable cases, but to those cases which are well developed and have gave symptoms. It is well to know all the elements in the case; then if you have administered a remedy and killed your patient, you know at least what you have done.

It is better to know what you have done if you have killed your patient, than to be ignorant of it and go on and kill some more in the same way.

A Dictionary of Practical Materia Medica, John Henry Clarke

Hepar sulphuris calcareum. An impure Sulphide of Calcium prepared by burning in a crucible the white interior of oyster shells with pure flowers of sulphur. Trituration.

Clinical.─Abscess. Amaurosis. Angina pectoris. Appetite, disordered. Asthma. Axilla, abscess in. Beard, eruptions of. Blepharitis. Boils. Breast, affections of. Bronchitis. Bubo. Burns. Carbuncle. Caries. Chilblains. Chlorosis. Cold. Constipation. Consumption. Cornea, ulceration of; opacity of. Cough. Croup. Diaphragmitis. Diarrhoea. Ear, affections of; polypus of. Eczema. Emphysema. Erysipelas. Eyes, affections of. Fester, tendency to. Glandular swellings. Haemoptysis. Haemorrhoids. Headache. Hectic. Herpes preputialis. Hip-joint disease. Hoarseness. Jaundice. Joints, affections of. Laryngitis. Leucorrhoea. Lips, swollen. Liver, affections of. Lungs, affections of. Lupus. Marasmus. Menorrhagia. Mouth, sore. Nipples, sore. Ovaries, affections of. Parametritis. Pleurisy. Pneumonia. Pregnancy, sickness of. Pruritus mercurialis. Pylorus, affections of. Quinsy. Rhagades. Rheumatism. Scarlatina. Scrofula. Skin, affections of. Spinal irritation. Stye. Suppuration. Syphilis. Tenesmus. Throat, sore. Urticaria. Wens. Whitlow. Whooping-cough.

Characteristics.─"Liver of Sulphur" is a name which was given by the old chemists to several sulphur compounds whose Colour was supposed to resemble that of liver. Before Hahnemann's time Hepar sulphuris calcareum, Sulphuret of lime, was used as an external remedy for itch, rheumatism, gout, goitre and scrofulous swellings. In 1794 Hahnemann proposed to use it internally to arrest mercurial salivation. A few years later it was tried (Teste thinks first by Dr. Busch of Strasburg) for asthma and pulmonary phthisis. That this was a happy inspiration Hahnemann's provings and clinical experience has thoroughly borne out. The Hepar of Hahnemann is not identical with ordinary sulphuret of lime, being prepared with oyster shells, instead of ordinary lime, in a special way. Neither is it identical in composition or properties with Calcium sulphate (Gypsum) of Schüssler. Being a chemical combination of Calcarea carb. and Sulph. it has some of the properties of both, but is very different from either, and though it is useful to compare them, Hepar must be studied as a separate entity. The one feature which more than any other characterises Hepar cases is over-sensitiveness. It runs throughout the remedy. "Any trouble occurring on the skin where there is a great sensitiveness to the slightest touch; patient can't bear to have even the clothes touch the part, or have it touched in any way. Exanthema, like nettle-rash, sore to the slightest touch. Skin hard to heal; inflammation of; sensitive soreness of," is Guernsey's admirable definition of this feature as it affects the skin and touch. But the sensitiveness is not confined to touch, there is excessive sensitiveness to the air; patient can't bear the least draught; and if a hand accidentally gets outside the bed-clothes it brings on an aggravation; sensitiveness to noise, to odours. The mind is no less "touchy" than the body. "Dissatisfaction with oneself and others; dreamy, atrabilious mood, a sort of ferocious spleen, as though one could murder a man in cold blood (even in persons who are generally of a merry and benevolent disposition)." This is from Teste, who says he has removed these symptoms with Hepar. Irritable and angry, feels inclined to kill any one who offends him. Another instance of the sensitiveness of Hepar is in relation to pain: the slightest pain causes fainting. There is also irritable heart. The sensitiveness to cold air is more to the dry cold air of Acon. and Bry. This distinguishes it from Nat. sulph. in asthma, which has < from damp cold (Nat. sulph. is Grauvogl's typical hydrogenoid remedy); and also fixes its applicability in croup. Hepar croup is accompanied with rather loose cough, with wheezing and rattling. Cough as if mucus would come up but it does not. The time of the Hepar croup is early morning (Acon. in evening). The least breath of cold air < the cough, or any uncovering. Another feature of Hepar is the sensation of a splinter or fish-bone in the throat. In quinsy with throbbing pain, where suppuration is imminent, Hepar is indicated. Throbbing, stabbing pains, with general rigor are characteristic. The relation of Hepar to the suppuration process is very marked. It meets the hectic condition generally and the process locally. I once cured with Hep. 6 a case of axillary abscess with a large collection of pus. The whole was absorbed without breaking. In an article published in Minneap. Hom. Mag., ii. 292, L. P. Foster distinguishes between Hepar, Calc. sul., and Kali sul., in their action on tissues. Kali s. acts on the epidermis; Hepar on lymphatic glandular system, skin and respiratory mucous membrane, Calc. s. acts much as Hep., only more deeply. Hep. acts on abscesses before they open, Calc. s. after. Foster cured a lady with Calc. s., high, of "several large ulcers in the gluteal region 3 in. in diameter and 3/4 in. deep, exposing the bone." The pain ceased immediately, and the cure was completed in two months. Calc. s. is suited to quinsy after it breaks, Hep. before. In this connection it may be well to speak of the relation of Hep. to Mercurius. Hahnemann's instinct led him to see in Hepar an antidote to mercurial poisoning, and it remains still the chief antidote, whether to the effects of massive doses or to over-action of the potencies. Silic. and Merc. are inimical, but if Hepar is given as an intermediary no unpleasant effects will occur. It follows Merc. when this ceases to help, or has aggravated, in rheumatism, quinsy, boils and suppurations. In a case of eczema pudendi in a young girl, 11, three months after puberty, the parts red and itching, Merc. was given and the whole body became covered with the rash; Hep. was then given and removed all immediately. "Sweats day and night without relief." It antidotes the sensitiveness of Merc. to atmospheric conditions. In the old days of mercurialisation one of the chief things to be avoided by a patient under the "course" was exposure to chill. Hepar has this same sensitiveness to chill and liability to take cold from every exposure. Coryza, nose swollen and sore to the touch, especially inside the alae. Boring at root of nose with catarrhal symptoms or headache is characteristic. Croupous inflammations of throat, respiratory organs, bowels and kidneys─the inner as well as the outer skin, in fact. The ulceration of the skin is peculiar. Guernsey thus describes it: "Ulcers with bloody pus; with sour-smelling pus; stinking pus; putrid ulcers; with redness around; with little pimples around─ten, twelve, or even as many as fifty may surround the large ulcer, and the ulcer sometimes spreads by the little pimples joining in. Painful; painful at the edge; suppurating; with pain as if sore; difficult to heal; inflamed; itching; looking like a lump of lead with a hole in it; cancerous ulcers." "Smelling like old cheese" is very characteristic of Hep. ulcers and discharges. The itching of Hep. is noteworthy; it occurs in connection with jaundice. It has cured cases of pruritus especially when of mercurial origin. In the respiratory organs there are suffocative attacks of breathing (in croup the child chokes in its coughing spells and there is much rattling). It meets many cases of asthma and whooping-cough. Respiration with mucous rattle; expiration in the morning, none in the evening; cough with expectoration during the day, none in the night (in croup no expectoration at night but only in the daytime─with the suffocative coughing spells; low, weak voice (Guernsey). There is a semi-paralytic condition of the rectum and bladder somewhat like that of Alumina. The stools are passed with great difficulty even when clay-like and soft. Fetid stools with a sour body-smell in children. Sour stools are also very marked in diarrhoea; and this maybe noted along with the desire of Hepar for acid things. Micturition is impeded; obliged to wait awhile before the urine passes, and then it flows slowly for many days. Never able to finish urinating; it seems as if some urine always remains behind in bladder. Urine drops vertically down. The urine is very acrid. There are complaints during micturition and after. Nocturnal emissions. Escape of prostatic fluid at any time, and at stool. Affections of the sexual organs occurring on the right side. Hepar is one of the great antipsorics. In his "Medicine of Experience" Hahnemann speaks of the itch-like eruptions caused by Hepar and its corrective properties in wool-worker's itch. It is suited to: The psoric, scrofulous, diathesis. Debilitated subjects. Great tendency to suppuration. Strumous, outrageously cross children. Torpid, lymphatic constitutions; persons with light hair and complexion, slow to act, muscles soft and flabby. Slow, torpid constitutions with lax fibre and light hair; great sensitiveness to slightest contact of ulcers, eruptions and parts affected. (These conditions differ from the Sulph. type: lean, stoop-shouldered; unclean-looking, aversion to warmth.) The symptoms are: < in the night; on awakening; when blowing the nose; from cold in general; in cold, dry weather; on single parts of the body getting cold; from getting the skin rubbed off; on uncovering the head; from surgical injuries in general; from lying on the painful side; from daylight; from pressure from without; from abuse of Mercury; during sleep; when swallowing, particularly when swallowing food (parts are so tender); while urinating; in clear, fine weather; in dry weather; in the least wind. Symptoms are: > from wrapping up the head; from warmth in general; the, air being warm; in damp and wet weather; from wrapping up the body warmly; by eating (a comfortable feeling after eating is very characteristic). There is marked periodicity in Hepar: every day; every four weeks (attack of paralysis); every four months (scabby eruptions on head); every winter (whitlows); spring and autumn, bilious attacks. The bends of the elbows and popliteal spaces are affected by Hep. In eye affections patient likes to have them covered lightly. The following case was cured by Hep. after Sul. and Calc. had failed. Pustular ophthalmia of left eye, > keeping eye closely covered with some soft fabric, < mornings, > as day advanced. Pimples surround affected eye.

Relations.─Antidoted by: Acet. ac., Bell., Cham., Sil. It antidotes: Metals, and especially mercurial preparations, Nit. ac., Calc., Iod., Kali iod., Cod-liver-oil. It removes the weakening effects of Ether. Compatible with: Aco., Arn., Bell., Lach., Merc., Nit. ac., Sil., Spo., Zinc. Complementary to: Calend. in injuries. Compare: In > from warmth: Ars., Calc., Nux v., Nux mos., Pso., Sil., Mag. m. In aversion to be washed Ant. c., Clem., Rhus, Sep., Spi., Sul. In aversion to be touched Ant. c., Ant. t., Cin., Sil., Thu. In irritable heart: Cact., Pho. In suppuration: Sil., Luet. (succession of abscesses), Calc. s., Merc. Every little scratch suppurates: Merc., Cham., Sil., Lyc. Cries during cough: (Arn., before and after; Bell. after), Sharp splinter or fish-bone sensation: Arg. n., Nit. ac., Sil., Fl. ac., Merc., Alm. Hasty speech and actions: Bell. (hasty speech, hasty drinking), Lach., Dulc., Sul. Little pimples round eye: Euphras., Phos. Croup: Aco. (Hep. follows Aco.; Aco. is anxious, high fever, distressed breathing); Spo. (dry, hard cough; little or no expectoration; starts from sleep choking, < before midnight; Hep. < after); Bro., Iod. Constipation: Alm., Bry., Nux, Nat. c. Sour stools: Mag. c., Calc., Rhe. Pains = fainting: Cham., Val., Verat. Sensitiveness of ulcers, etc.: Lach. (absence of sensitiveness, Graph.). Teste puts Hep. in his Pulsatilla group with Sil., Calc., Graph., and Phos.

Causation.─Cold, dry winds. Injuries. Mercury. Suppressed eruptions.

SYMPTOMS.

1. Mind.─Sadness and desire to weep.─Anguish and extreme apprehension, esp. in evening, and sometimes suggesting suicide.─Ill-humour; dislike even to see friends.─Excessive irritability.─Vexation and passion, with hasty speech and excessive weakness of memory.─The slightest cause irritates him and makes him extremely vehement.─A sort of furious spleen as though one could murder a man in cold blood.─Anger; would have no hesitation in killing a man who offended him, only he knows better.─Visions in the morning, in bed.

2. Head.─Vertigo on moving the head, as well as from the motion of a carriage, or in the evening, with nausea.─Sense of swashing in the head.─Vertigo, with loss of intellectual power, and obscuration of sight.─Headache in the morning, excited by the slightest shock (< from every contusion).─Headache at night, on moving the eyes; the forehead seems about to be torn asunder.─Pain in the head, as if a nail were driven into it.─Boring headache from without to within in r. temple; on one side of head; at root of nose, when waking from sleep; < by motion and stooping.─Pressure in the head, semi-lateral, as from a plug or dull nail, at night and when waking in the morning; < when moving the eyes and on stooping; > when rising and from binding the head up tight.─Pressure on the temples and on the vertex, with palpitation of the heart in the evening.─Tension above root of nose.─Aching in the forehead, like a boil, from midnight till morning.─Pain, as from ulceration, in the head, directly above the eyes, every evening, or else at night, in bed.─Shootings in the head, esp. after having been in the open air, and on stooping, or at night, as if the head were going to burst.─Piercing in the head, esp. at the root of the nose, every morning.─Falling off of the hair, with very sore, painful pimples and large bald spots on the scalp; sensitiveness of the scalp to contact, with burning and itching in the morning after rising (after abuse of Mercury).─Cold sweat on the head.─Cold, clammy perspiration, smelling sour, principally on the head and face, with aversion to be uncovered; < from least exercise and during night; > from warmth and rest.─Disposition to catch cold when uncovering the head.─Tuberosities on the head, with pain as of excoriation, on their being touched; > from covering the head warm and from perspiration.─Humid scabs on the head, feeling sore, of fetid smell; itching violently on rising in the morning and feeling sore on scratching.─The head is bent backward, with swelling below the larynx, with violent pulsation of the carotid arteries and rattling breathing (in croup).

3. Eyes.─Pain, as if the eyes were driven, or drawn back, into the head.─Painful and difficult movement of the eyes.─Heat, pressure and shootings in the eyes.─Throbbing in and about the eye.─Pressure in the eyes, as from a foreign body (sand).─Pain, as from ulceration, immediately above the eye, every evening.─Inflammation of the eyes and of the eyelids, sometimes erysipelatous, with pain as of a bruise, and of excoriation, on being touched.─Pimples above the eyes, and on the eyelids.─Specks and ulcers on the cornea.─Nocturnal lachrymation and agglutination of the eyelids.─Spasmodic closing of the eyelids (at night).─Eyes prominent.─Obscuration of the sight on reading.─Photophobia by day, and by candle-light.─The eyes ache from the bright light of day, when moving them.─Confusion of sight, in the evening, by candle-light, alternately with clearness of vision.─The objects appear to be red.

4. Ears.─Darting pain in the ears.─Shootings in the ears, on blowing the nose.─Detonation in the ear, when blowing the nose.─Heat, redness, and itching in the ears.─Itching of the external ear.─Discharge of pus from the ears, which is sometimes fetid.─Scabs behind and on the ears.─Hardness of hearing, with pulsations and buzzings in the ears, esp. in the evening in bed.─Increase of cerumen.

5. Nose.─Inflammation, redness, and swelling of the nose.─Pain, as of a bruise, and of excoriation in the nose, on its being touched.─Burning pain, as from ulceration and scabs in the nostrils.─Epistaxis, in the morning, and after singing.─Want of, or increased power of smell.─Coryza, chiefly on one side, with roughness in the throat, inflammatory swelling of the nose, fever, or painful weariness in all the limbs.

6. Face.─Face yellow, with blue circles round the eyes.─Face burning, and of a deep red.─Nocturnal heat of face.─Erysipelatous inflammation and swelling of the face and cheeks, with pricking tension, and eruption of vesicles.─Drawing and tearing pains, commencing from the cheeks, and extending to the ears and the temples.─Pains in the bones of the face, on the parts being touched.─Pimples on the forehead, which disappear in the open air.─Swelling of the lips, with tension and pains on touching them.─Eruption at the corners of the mouth.─Ulcer in the corner of the mouth.─Ulceration at the commissure of the lips.─The middle of the lower lip becomes chapped.─Blisters (boils) on the lips, chin, and neck, painful on being touched.─Eruption on the face, scurfy, very painful to the touch.─Vesicles on the chin.─Shootings in the articulation of the jaw, on opening the mouth.

7. Teeth.─Odontalgia, with starting and drawing pains, < by closing the teeth, by eating, and in a hot room.─Looseness of the teeth.─The hollow teeth feel too long.─Swelling and inflammation of the gums, which are painful when touched.─Ulcer on the gums and in the mouth, with a base resembling lard.─The gums and mouth bleed readily.

8. Mouth.─Accumulation of water in the mouth.─Salivation, hawking up of mucus.─The tip of the tongue is very painful and feels sore.─Speech hoarse and precipitate.

9. Throat.─Sore throat, as if there were a peg in it, or an internal tumour.─Painful scraping in the throat, with difficulty in speaking and in swallowing the saliva.─Hawking up of mucus.─Shootings in the throat, and even into the ears, as from splinters, on swallowing, coughing, breathing, and on turning the head.─Violent pressure on the throat, with danger of suffocation.─Deglutition impeded and almost impossible, without great efforts.─Dryness in the throat.─Swelling of the amygdalae.

10. Appetite.─Loss of appetite.─Bitterness of the mouth and of food.─Earth-like and bitter taste in the throat, with natural taste of food.─Violent thirst.─Unusual hunger in the forenoon.─Bulimy.─Desire only for acids, wine, sour and strong-tasting substances, or highly seasoned things.─Dislike to fat.─Desire for wine.

11. Stomach.─Risings, with burning sensation in the throat.─Burning in the stomach.─Attacks of nausea, sometimes with cold and paleness.─Nausea, with inclination to vomit in the morning.─Acid, bilious, greenish, or mucous and sanguineous vomitings.─Frequent and easy derangement of the stomach.─Pressure at the stomach, even after eating very little.─Pressure in stomach, as if lead were in it.─Swelling in the region of the stomach, with pressive pains.─Pressure, inflation and sensation, as if there were Something weighing heavily on the epigastrium, with inability to continue seated, and to endure tight clothes.

12. Abdomen.─Shootings in the region of the spleen.─Splenetic stitches when walking.─Shootings in the hepatic region, esp. when walking.─Pain, from a bruise in the in the morning.─Cramps and contractive pains in the abdomen.─Sensation of violent clawing in the umbilical region, with nausea, anxiety, and heat of the cheeks.─Cutting pains.─Pain, as from ulceration in the abdomen.─Shootings in abdomen, esp. on l. side.─Swelling and suppuration of the inguinal glands (buboes).─(Rumbling in the abdomen.).─Incarceration and difficult emission of flatus, esp. in the morning.

13. Stool and Anus.─Constipation; hard and dry faeces.─Difficult emission of scanty and soft excrement, with urgent want, and tenesmus.─Diarrhoea of feculent matter with cutting pains.─Whitish diarrhoea, of an acidulous smell, esp. in children.─Dysenteric evacuations, greenish, or of a clay-colour, with evacuation of sanguineous mucus.─After the evacuation, pain, as of excoriation, and sanious discharge from the anus.─Haemorrhage from rectum, with soft stool.─Burning at the rectum.─Protrusion of haemorrhoidal pimples from the rectum.─Perspiration at the perineum.

14. Urinary Organs.─Urine slow and turbid, with whitish sediment.─The urine is passed slowly, with difficulty; drops out perpendicularly.─Abundant secretion of pale urine, with pressure on the bladder.─Acrid, corrosive (corroding the prepuce), or pale and watery, or deep-red, and hot urine.─Nocturnal emission of urine.─Wetting the bed (at night).─Emission of blood after urination.─Burning in the urethra during micturition.─Stitches in the urethra.─Redness and inflammation of the orifice of the urethra.─Discharge of mucus from the urethra.

15. Male Sexual Organs.─Weakness of the genital parts.─Itching of the penis (glans, fraenulum).─Smarting, excoriation, and oozing, between the thigh and the scrotum.─Cancerous ulcer on the prepuce.─Painful, cramp-like, and tensive erections.─Absence of sexual desire and of erections.─Erections without energy, during coition.─Excitement of the genital parts, as if for emission.─Flow of prostatic fluid, esp. after making water, and during a difficult evacuation.

16. Female Sexual Organs.─Excoriation of the vulva, and between the thighs.─Congestion of blood to the uterus.─Irritation of ovaries (l.); with swelling; and great sensitiveness.─Discharge of blood between the periods, with inflation of the abdomen.─Catamenia too long delayed, and diminished.─Leucorrhoea, with smarting at the vulva.─Cancerous ulcer on the breast, with stinging-burning of the edges, smelling like old cheese.─Itching nipples.

17. Respiratory Organs.─Hoarseness.─Pain and great sensitiveness (to cold) of the larynx, with weak and rough voice, emaciation, hectic fever, and sleeplessness.─Rattling breathing (during sleep).─Swelling below the larynx.─Roughness in the throat.─Croup, with swelling under the larynx.─Permanent pain in the larynx, < by pressure, speech, coughing, and breathing.─Weakness of the organs of speech, and of the chest, causing a hindrance to speak loud.─Cough, excited by irritation or pain in the larynx.─Titillation as from dust in the throat, inducing cough, which is deep, wheezing, with expectoration, only in the morning, of mucus, bloody, or like pus, generally tasting sour or sweet.─Cough, deep and dull, excited by difficulty of respiration.─Suffocating, violent cough, with retching.─Cough, similar to whooping-cough.─Cough after drinking.─Dry cough, in the evening, on taking cold in any part of the body, or when lying on the bed.─Cough worse from evening till midnight.─Cough caused by a limb getting cold; from eating or drinking anything cold; from cold air; when lying in bed; from talking, crying.─Attacks of dry, rough, and hollow cough, with anguish and suffocation, often ending in lachrymation.─Barking cough.─Cough, with spitting, of blood.─Cough, with abundant expectoration of mucus.─Ringing, and pain in the head during the cough, as if it were going to burst.─Sneezing after the cough.─Bronchitis.

18. Chest.─Anxious, hoarse, wheezing respiration, with danger of suffocation on lying down.─Soreness in the chest.─Attacks of suffocation, which force the patient to throw back the head.─Shortness of breath.─Weakness of the chest; cannot talk from weakness.─Tenacious mucus in the chest.─Spasmodic constriction of the chest.─Frequent want to breathe deeply, as after running.─Shootings in the chest on breathing and walking.─Pimples and furunculi on the chest, with lancinations, and pain as of excoriation on the part being touched.

19. Heart.─Violent palpitation of the heart, with fine stitches in the heart and l. half of chest.─Irritability of the heart.

20. Neck and Back.─Swellings on the neck, painful when touched.─Violent pulsation of the carotid arteries.─Burning, shooting pain in the region of the loins.─Pain, as from a bruise in the loins, extending to the thighs.─Shootings and pulling in the back, between the shoulder-blades and in the muscles of the neck.─Stitches and rheumatic pains in the back.─Nocturnal tension in the back, on turning in bed.─Fetid sweat under the armpits.─Suppuration of the axillary glands.

22. Upper Limbs.─Pain, as from a bruise, in the bones of the arm (humeri).─Arthritic swelling of the hand, of the fingers, and of the joints of the fingers, with heat, redness, and pain, as of dislocation during movement.─Skin of the hands cracked, rough and dry.─Granulated eruption on the hands and on the wrists.─Nettle-rash on the hands and on the fingers.─Cold perspiration of the hands.─Tingling in the tips of the fingers.─Itching in the palms of the hands.─Steatoma at the point of the elbow.─Easy dislocation of the fingers.─Fingers dead.─Panaris.

23. Lower Limbs.─Pain in the buttocks on sitting down.─Furunculi on the buttocks.─Pain, as from a bruise, on the thighs.─Painful tension in the thighs, which prevents sleep.─Frequent sudden lassitude of the limbs, when walking.─The hip-joint feels sore, as if sprained when walking.─Pain as from bruises in the knee.─Prickings in both heels.─Tingling in the toes.─Burning, stinging pain in the toes.─Swelling of the knees.─Cramps in the calves of the legs, the soles of the feet, and the toes.─Feet burning.─Swelling of the feet, and in the ankle-bones, with difficulty of respiration.─Red, rheumatic swelling in the ankle-bones, with pain, which increases at night.─Cracks in the feet.─Shootings in the corns.

24. Generalities.─Tearing or paralytic pullings in the limbs, esp. in the morning on walking.─Weakness in all the limbs.─Pains, as from excoriation or bruising on various places, when they are touched.─Rheumatic pains in the limbs and shootings in the joints.─Arthritic swellings, with heat, redness, and pains as from dislocation.─Swelling, inflammation, and ulceration of the glands.─Appearance or aggravation of the pains at night, esp. during the chills.─Emaciation, sometimes with anguish, irritability, shiverings in the back, redness of the cheeks, sleeplessness, etc.─Physical depression and trembling after smoking tobacco, or on walking in the open air, with heat and anxiety.─Fainting fit, esp. in the evening, from moderate pains.

25. Skin.─Erysipelatous inflammations, even with swelling and vesicles.─Yellowish colour of the skin, esp. on the face, with yellowish colour of the sclerotica, and urine red like blood.─Jaundice, with much itching.─Burning itching in the body, with white vesicles after scratching.─Nettle-rash.─Eruption of pimples and tubercles, painful to the touch.─Unhealthy skin; every injury tends to suppuration and ulceration.─Promotes suppuration.─Cracks in the skin.─Putrid ulcers, smelling like old rotten cheese, and easily bleeding, with shootings, sensation of gnawing (esp. at night), or with burning and pulsative pains.─Cancerous ulcers.─Suppurations; esp. after previous inflammations.─Panaris.─Caries.

26. Sleep.─Strong desire to sleep, morning and evening, with convulsive yawning.─Unquiet sleep, with the head turned back.─Prolonged sleep with stupefaction, as in lethargy.─Sleeplessness, caused by a great flow of ideas.─Dreams of fire, sickness, danger, guns, etc.─At night, gastric sufferings, headache, agitation, starting of the limbs, and dry heat.─Starts at night, during sleep, as from want of air, with tears and great anguish.─Wakes at night with an erection and an urgent desire to urinate.─The side on which he lies at night becomes painfully sore; he must change his position.

27. Fever.─Pulse hard, full, accelerated; at times intermitting.─Shuddering and shivering, esp. in the open air.─Shiverings, with chattering of the teeth and coldness in the hands and feet, followed by heat and sweat, esp. on chest and forehead, with little thirst.─Chill in the evening, 6 or 7 p.m.─Chilliness and heat alternating during the day, with photophobia.─Chilliness at night; in bed aggravating all the symptoms.─Bitterness in the mouth, afterwards shivering with thirst; an hour after, heat with sleep, after which, vomiting and cephalalgia.─Dry heat at night.─Flushes of heat with sweat.─Burning, feverish heat, with redness of the face and violent thirst.─Strong disposition to perspire in the daytime, on the least effort, and on the least movement.─Profuse perspiration day and night.─Perspiration easily excited through the day, esp. from exertions of the mind.─Nocturnal sweat.─Sweat in the morning.─Night and morning sweat, with thirst.─Viscid acid sweat.─Cold, clammy, or sour or offensively smelling perspiration.─Intermittent fever; first chills, then thirst, and, an hour later, much heat, with interrupted sleep.

Keynotes and Characteristics with Comparisons of Some of the Leading Remedies of the Materia Medica (Allen's Keynotes), Henry Clay Allen

Sulphuret of Lime (CaS)

For torpid lymphatic constitutions; persons with light hair and complexion, slow to act, muscles soft and flabby. The slightest injury causes suppression (Graph., Mer.). Diseases where the system has been injured by the abuse of Mercury. In diseases where suppuration seems inevitable, Hepar may open the abscess and hasten the cure. Oversensitive, physically and mentally; the slightest cause irritates him; quick, hasty speech and hasty drinking. Patient is peevish, angry at the least trifle; hypochondriacal; unreasonably anxious. Extremely sensitive to cold air, imagines he can feel the air if a door is open in the next room; must be wrapped up to the face even in hot weather (Psor.); cannot bear to be uncovered (Nux - cannot bear to be covered, Camp., Sec.); take cold from slightest exposure to fresh air (Tub.). Urine: flow impeded; voided slowly, without force, drops vertically; is obliged to wait a while before it passes; bladder weak, is unable to finish, seems as if some urine always remains (Alum., Sil.). Cough: when any part of the body is uncovered (Rhus); croupy, choking, strangling; from exposure to dry west wind, the land wind (Acon.). Asthma: breathing, anxious, wheezing, rattling; short, deep breathing, threatens suffocation; must bend head back and sit up; after suppressed eruption (Psor.). Croup: after exposure to dry cold wind (Acon.); deep, rough, barking cough, with hoarseness and rattling of mucus; < cold air, cold drinks, before mid-night or toward morning. Sensation of a splinter, fish bone or plug in the throat (Arg. n., Nit. ac.); quinsy, when suppuration threatens; chronic hypertrophy, with hardness of hearing (Bar., Lyc., Plumb., Psor.). The skin is very sensitive to touch, cannot bear even clothes to touch affected parts (Lach. - sensitive to slightest touch, but can bear hard pressure, Cinch.). Skin affections extremely sensitive to touch, the pain often causing fainting. Ulcers herpes surrounded by little pimples or pustules and spread by coalescing. Middle of lower lip cracked (Am. c., Nat. m. - cracks in commissures, Cund.). Eyeballs: sore to touch; pain as if they would be pulled back into head (Olean., Paris). Diarrhoea: of children with sour smell (Cal., Mag. c. - child and stool have a sour smell, Rheum); clay colored stool (Cal., Pod.). Sweats: profusely day and night without relief; perspiration sour, offensive; easily, on every mental or physical exertion (Psor., Sep.).

Relations. - Complementary: to, Calendula in injuries of soft parts. Hepar antidotes: bad effects of mercury and other metals, iodine, iodide of potash, cod-liver oil; renders patient less susceptable to atmospheric changes and cold air. Compare: The psoric skin affections of Sulphur are dry, itching, > by scratching, and not sensitive to touch; while in Hepar the skin is unhealthy, suppurating, moist, and extremely sensitive to touch.

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

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

Leaders In Homoeopathic Therapeutics, Eugene Beauharnais Nash

Hypersensitive to touch, pain, cold air; fainting with the pain.

General tendency to suppurations; even slight injuries or scratches on the skin suppurate.

Tendency to croupy exudations (larynx and kidneys; and mucous membrane).

Atony; stools passed with great difficulty, even when soft; urine flows slowly, must wait for it, then drops vertically down without force.

Sour diarrhoea; whole child smells sour.

Coughs; croup, bronchitis, consumption; < when exposed to least cold air.

Modalities: < exposure to dry cold air; > in moist wet weather.

Like Sulphur, Hepar is adapted to the psoric, scrofulous diathesis.

* * * * *

This remedy standing half-way between those two great anti-psorics, Calcarea carb. and Sulphur, has some very strong characteristics which guide to its use in a variety of ailments. Its strongest characteristic is its hypersensitiveness to touch, pain, and cold air. The patient is so sensitive to pain that she faints away, even when it is slight. If there are inflammation or swelling in any locality, or even eruptions on the skin, they are so sensitive that she cannot bear to have them touched, or even to have the cold air to blow upon them. This is like China off., only that while the latter is sensitive to the lightest touch it can bear hard pressure. (Remedies especially < in cold air are Arsenicum alb., Calcarea ost., Hepar sul., Nux vomica, Psorinum, Silicea, Tuberculinum.). This supersensitiveness to pain runs all through the drug. It is mental as well as physical, for the slightest cause irritates with hasty speech and vehemence. Next to this is the power of Hepar sulph. over the suppurative stage of local inflammations. It comes in only when pus is about to form, or is already formed. If given very high in the first case (that is before pus is formed), and not repeated too soon or often, we may prevent suppuration and check the whole inflammatory process. But if pus is already formed, it will hasten the pointing and discharge and help along the healing of the ulcer afterwards. I am not at all sure, as is generally taught, that it is necessary to give it low to hasten suppuration. The most rapid pointing, opening, and perfect healing I ever saw was in the case of a large glandular swelling on the neck of a child, under the action of the c. m. potency. Hepar has a general tendency to suppuration, for even the eruptions on the skin are liable to form matter, and slight injuries suppurate. (Graphites, Mercurius, Petroleum.) This remedy is very valuable in diseases of the respiratory organs. I have found it very useful in cases of chronic catarrh, when the nose stopped up every time the patient went out into the cold air. He says it seems as if I get a new cold every time I get a breath of fresh air (Tuberculinum). It is relieved in a warm room. In croup it has been, ever since Boenninghausen prescribed his celebrated five powders, one of our standard remedies. We do not use the five powders as Boenninghausen did in a certain order, but only use them according to indications. Hepar croup is accompanied with rather loose cough, with wheezing and rattling. Cough as if mucus would come up, but it does not. It is seldom indicated at first; but oftener comes in after Aconite or Spongia. Like Aconite it seems most effectual in those cases brought on by exposure to dry cold air; but the Aconite croup comes on in the evening after first sleep and Hepar in the early morning hours. This tendency to croupy exudations on mucous membranes seems characteristic of Hepar and is not confined to the respiratory organs. Kafka uses it on the ground of its ability to control such conditions in post scarlatinal dropsy, to prevent or cure, and claims great success for it. I believe it to be one of the best prophylactics in such cases, for the reason that during and after the desquamative stage the skin is unusually susceptible to the effects of chill in cold air, and this is in accordance with the leading characteristic of this remedy. It fortifies the patient against such atmospheric influence.

In croup, as in other affections of Hepar, the cough, difficult breathing and all other symptoms are aggravated by the least of breath cold air, which the little patient must be carefully guarded against. Traveling downward the larynx is attacked, then the bronchia, and even the lungs, and the formation of croupy exudates will take place if not checked by the remedy. The breathing in all these cases becomes rattling, anxious, wheezing, even to threatened suffocation, so that the patient seems asthmatic. In. these cases it is often able to relieve, especially if this condition follows a hard cold and the acute inflammatory symptoms have been controlled by Aconite or some other indicated remedy.

In chronic asthma, Hepar often resembles Natrum sulphuricum, but there is this diagnostic difference, which is very valuable. The Hepar asthma is worse in dry cold air and better in damp, while Natrum sulph. is exactly the opposite, like Dulcamara. There is no other remedy that I know that has the amelioration so strongly in damp weather as Hepar sulphur. One characteristic must not be forgotten, viz.: "Coughs when any part of the body becomes uncovered". (Baryta and Rhus tox.). This is found in croup, laryngitis, bronchitis and consumption, and not only is the cough worse, but the whole case is aggravated. Then, again, it must be remembered that this is one of our strongest anti-psorics, and for that reason should be thought of for all respiratory ailments for which it has such a strong affinity, especially when such ailments have followed a suppressed or retrocedent eruption on the skin.

In accordance with its great power over all suppurative processes, it should come to mind in abscess of the lungs, of course in all cases when indicated by the symptoms in toto. Upon the throat we have 1st, "sticking in the throat, as from a splinter, on swallowing, extending to the ear, also on yawning." "Sensation as if a fish bone or splinter were sticking in the throat" (Argentum nitricum, Dolichos and Nitric acid), but probably the condition where Hepar is oftenest of use in throat trouble is in that distressing complaint, quinsy.

Here, as in croup, it is not generally indicated in the beginning. Having had much success and experience in this disease, I may here give the results of the application of several remedies and their indications:

Belladonna.–High fever, great swelling, and redness, headache, throbbing carotids.

Mercurius vivus.–Either side, foetid breath, flabby, moist, indented tongue, and sweat without relief.

Mercurius proto-iodatus. – same symptoms, but begins on right side, and tongue thickly coated yellow at the base.

Lachesis.–Left side extending to right, great sensitiveness to touch, and aggravation after sleep.

Lycopodium.–Begins right side, extends to left, with tongue swollen and inclined to protrude from the mouth, and stuffing up of nose.

Lac caninum.–Alternates sides, one day worse on one, and the next on the other.

Hepar sulph.–When notwithstanding all other remedies the case seems bound to suppurate and there is much throbbing pain. Now with each of these remedies I have aborted many cases in old quinsy subjects, who never expected to, and were told by old school physicians that they never could, get well, without suppuration, and in the end have cured them of all tendency thereto. I will add here that Hepar sulphur, is also a good remedy in chronic hypertrophy of tonsils, with hardness of hearing. In these cases which are generally very intractable, Baryta carbonica, Lycopodium, Plumbum, and others are also to be consulted according to indications.

Upon the alimentary canal Hepar has a decided influence. We have already noticed its action upon the throat. The stomach is inclined to be out of order, and there is a "longing for acid things". (Veratrum alb.) This is often the case in chronic dyspepsia and Hepar helps. This condition of the stomach is sometimes found in marasmus of children. It is often accompanied by diarrhoea, and a very important feature is that the diarrhea is sour; indeed the whole child seems to smell sour no matter how much it is bathed. The sour stool is also very prominently under Magnesia carbonica and Calcarea carbonica. Then there is another condition of the bowels, namely, a kind of atony. The stools are passed with great difficulty, even though they are soft and clay-like, as they sometimes are under this remedy. This state of atony is also found in the bladder.

"Micturition impeded, he is obliged to wait awhile before the urine passes, and then it flows slowly for many days." "He is never able to finish urinating; it seems as if some urine always remains behind in the bladder." "Weakness of the bladder, the urine drops vertically down and he is obliged to wait awhile before any passes." This inability to expel makes one think of Alumina and Veratrum album and Silicea. Again, Hepar sulph. is a great "sweat" remedy, either partial or general. It may, for instance, come in after Mercurius in rheumatism, in which the patient "sweats day and night without relief", and Mercurius does not help. So, too, with quinsy, and in large boils and swellings; and by the way Hepar sulph. is one of our best remedies after Mercurius either in homoeopathic practice, or as an antidote to old school poisoning so also is it the leading antidote to Iodide of Potassa poisoning from the same source. We could not well do without this valuable remedy.