Homeopathic Materia Medica

Lectures on Homoeopathic Materia Medica, James Tyler Kent

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

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

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

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

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

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

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

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

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

Stomach: When cerebro-spinal meningitis has gone on until the patient is emaciated, when remedies have seemed but to palliate momentarily, and the whole body is inclined backwards, and there is vomiting of everything, even the simplest article taken into the stomach, the tongue is red and raw, and there is constant nausea and vomiting of bile, Ipecac. will cure.

Ipecac. cures inveterate cases of gastritis when even a drop of water will not stay down; everything put in the stomach is vomited, continuous gagging, sharp pain in the stomach, pain in the back, below the shoulder blades, as if it would break, vomiting of bile, continuous nausea and great prostration. Irritable stomach. It also cures when the abdomen is distended, and sensitive, a tympanitic state, when there is vomiting of bile.

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

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

Chest: The chest complaints of Ipecac. are interesting. Ipecac. is especially the infant's friend and is commonly indicated in the bronchitis of infancy. The usual bad cold that ends in chest trouble in infants is a bronchitis.

It is very seldom that an infant gets a true pneumonia, it is generally a bronchitis with coarse rattling. The child coughs, gags and suffocates, and there is coarse rattling which can be heard throughout the room, and the trouble has come on pretty rapidly. The child is pale, looks dreadfully sick, and sometimes looks very anxious. The nose is drawn in as if dangerously ill, and the breathing is such as appears in a dangerous case. Ipecac. will sometimes modify this into a very simple case, break up the cold, and cure the child.

In the old books, the pneumonia of infancy had a distinct and separate description, and the typical symptoms were those of Ipecac. You will see a great similarity of symptoms when you study Ipecac. and Ant. tart. together in chest troubles. If you have been studying them together, you will say,

"How do you distinguish them; they both have rattling cough and breathing, and both have the vomiting?"

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

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

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

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

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

Haemorrhages: I have hinted at the haemorrhages, and these open out a great field for Ipecac. I could not practice medicine without ipecac., because of its importance in hemorrhages. When I say haemorrhages, I do not mean those from cut arteries, I do not mean haemorrhages where surgery must come in; I mean such as uterine haemorrhages, haemorrhages from the kidneys, from the bowels, from the stomach, from the lungs.

You must know your remedies in haemorrhages; if you do not, you will be forced to use mechanical means; but the homeopathist who is well instructed is able to do without them. In the severest form of uterine hemorrhages, the homeopathic physician is able to do without mechanical means, except when mechanical means are causing the haemorrhage.

This does not relate to hourglass contractions, it does not relate to conditions when the after birth is retained, or when the uterus has a foreign substance in it, because under such circumstances manipulation is necessary.

A distinction must be made. But when we have simply the pure dynamic element to consider, simply and purely a relaxed surface that is bleeding, the remedy is the only thing that will do the work properly. When the uterus is continuously oozing, but every little while the flow increases to a gush, and with every little gush of bright red blood the woman thinks she is going to faint, or there is gasping, and the quantity of the flow is not sufficient to account for such prostration, nausea, syncope, pallor, Ipecac. is the remedy.

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

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

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

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

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

Colds: Then there are the "colds."

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

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

The irritation comes on suddenly, and the mucous membrane inflames so rapidly that the parts become purple, turgescent, and bleeding seems to be the only natural relief. Stoppage of the nose and loss of smell; the nose becomes so stuffed up that he cannot breathe through it.

With the head symptoms, with the colds, with the whooping cough, with the chill, and with many of the inflammatory complaints, the face becomes flushed, bright red, or bluish red, and the lips blue; with the chill the lips and the finger nails are blue. The chill is violent, sometimes congestive in character and often a rigor. The whole frame shakes, and the teeth chatter.

There are old incurable cases of asthma that are palliated by Ipecac. and carry around a bottle of it from which they say they get much relief. It is useful in cases of humid asthma, in cases of asthmatic bronchitis, when they suffer from the damp weather and from sudden weather changes; every little cold rouses up this bronchial attack, and he suffocates and gags when he coughs, or spits up a little blood.

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

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

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

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

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

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

When the eruption does not come out, or an eruption has been driven back by cold, sometimes acute manifestations of stomach and bowels follow and colds settle in the chest from suppressed eruptions, Ipecac. will also cure erysipelas, when there is the vomiting, the chill, the pain in the back, the thirstlessness and the overwhelming nausea.

Ipecac. is often sufficient for the nausea and vomiting when the scarlet fever rash is slow to come out. Instead of the rash coming out as it should, Ipecac. symptoms come on in the stomach with nausea and vomiting. Ipecac. will check the nausea and vomiting, will bring out the eruption, and the disease will run a milder course.

A Dictionary of Practical Materia Medica, John Henry Clarke

Cephaëlis ipecacuanha. N. O. Rubiaceae. Tincture and trituration of the dried root.

Clinical.─Anaemia. Asthma. Bronchitis. Catarrh. Cholera. Consumption. Convulsions. Cough. Deafness. Diarrhoea. Dysentery. Enteric fever. Eyes, affections of. Gall-stone colic. Gastric Ulcer. Haematemesis. Haemorrhage. Haemorrhoids. Hysteria. Intermittent fever. Menstruation, disorders of. Opium habit. Pregnancy, disorders of. Remittent fever. Salivation. Tetanus. Toothache. Vomiting. Whooping-cough. Worm-fever. Yellow-fever.

Characteristics.─The well-known emetic effect of Ipecacuanha Wine gives a rough keynote for the use of Ipec. in homoeopathy. Wherever ailments are associated with the presence of constant nausea Ipec. is very likely to be of use. The special form of nausea is a constant but unavailing desire to vomit; or immediately after vomiting there is, instead of relief, a desire to vomit again. With this there is a clean or not very dirty tongue. There is profuse salivation with the nausea. The nausea of Ipec. is oftenest met with in affections of the stomach and bowels, of the respiratory organs, and in fevers. In the stomach itself there is a symptom which is very characteristic of the remedy, a feeling "as if the stomach were hanging down relaxed." There is disgust at the stomach for food; empty vomiting; vomiting of bile; of blood. No > by vomiting. The stomach disorder may be occasioned by rich food-pork, pastry, fruits, candy, ice-cream. The stomachic disgust of the remedy is depicted on the countenance, which expresses nausea. The corners of the mouth are drawn down. Blue rings round the eyes. Sometimes the mental state corresponds: "Moroseness and contempt for everything"; "Disdainful humour." The irritability of the elders becomes in children crying and screaming. Another mental symptom is "full of desires they know not for what." Ipec. is a botanic relative of China, and it is also an antidote to the latter; (it is also closely allied to Viola odorata). Perhaps the relationship of Ipec. to China may have something to do with its large sphere of usefulness in intermittent fever. Jahr recommended that in all cases of intermittents in which no other remedy is particularly indicated Ipec. should be given to begin with. It will either cure the case or bring out more definitely indications for another remedy. I have frequently found this advice useful; and it occurs to me that as most intermittents have been treated with quinine it is through its antidotal properties that Ipec. exerts some of its good effects. It has a strongly marked periodic action. A special indication for it is: Nausea through all the stages. Other indications are: "Stages completely mixed up short chill, followed by long fever." Ipec. has many bone pains, in the head and elsewhere. Pains as if bones were all torn to pieces. Ipec. is given as an expectorant in old-school practice, and is supposed to act by its nauseating properties. But homoeopaths have proved that nauseating doses are neither necessary nor desirable. The cough of Ipec. is dry, spasmodic, constricted, asthmatic. "Violent degree of dyspnoea, with wheezing and great weight, and anxiety about the precordia." "Threatened suffocation from accumulation of mucus." In whooping-cough a characteristic is the spasmodic rigidity of the patient. "Child loses breath, turns pale, stiff, and blue; strangling with gagging and vomiting of mucus; bleeding from nose or mouth." The great keynote, subject to slight variations, is─mental depression with tissue irritability. The tissue irritability of Ipec. is severe and urgent, but superficial; that of Ars., deep-seated, diffuse, and burning; that of Ferrum involves tissue, as with Ars., but is mostly painless (Cooper). Ipec. is a medicine of great importance in haemorrhages. The blood is bright red and the flow steady. A grand keynote for Ipec. in haemorrhages (whether of lungs, bowels, uterus, or other parts) is nausea with the haemorrhage. Guernsey thus describes the effect of Ipec. in the female sexual sphere, in which the haemorrhagic power of the remedy is of the highest importance: "Threatened abortion; often with a sharp pain around the umbilicus, which runs downward to the uterus, with constant nausea and discharge of bright red blood; discharge of blood before the proper period; metrorrhagia, often after confinement, which is heralded by a low pulse, nausea, etc.; there is a steady flow of bright red blood, which may soak through the bed to the floor, or may run over the foot of the bed. (Where there is this steady flow of bright red blood give Ipec., and do not resort to applications, manipulations, etc.) Menstruation too early and too profuse; deficient labour pains, and with the pains there is a great deal of suffering, but no good is accomplished, the suffering is caused by the above-named pain about the umbilicus, moving to the uterus." Some of the pains of Ipec. run from above down; some from left to right (cutting pain in abdomen). There is a remarkable headache "as if bruised, all through the bones of the head and down into the root of the tongue." Nausea is generally an accompaniment. Brain feels bruised, pain piercing to roots of teeth. There is also a sick headache originating in the stomach, the nausea preceding the headache and persisting all through. Teste has used the remedy with good effect in "constrictive and contusive headaches seated in left parietal region, coming on every day at 11 a.m., increasing gradually until the pain became intolerable, then decreasing in the same manner" and ceasing completely at 2 p.m. Another sphere in which Ipec. has shown great curative power is the eye. According to Allen granulations of the lids have been cured by the instillation of the dilutions. Also subacute inflammation of the cornea, with intense pain and great photophobia. Pustular conjunctivitis, especially in children. Inflammation with tearing pain and gushing of tears. Violent neuralgia of eyeballs, shooting in the head, with gushes of tears, nausea, etc. Dr. Nancy T. Williams (H. R., xi. 65) has cured several cases of gall-stone colic with Ipec. 6. The relief was prompt and lasting. On the strength of this symptom of Hahnemann's, "external chilliness with internal heat," Mahony gave Ipec. 200 to an army sergeant, 49, invalided for aneurism, who had this symptom while recovering from a catarrhal attack: coldness of hands and feet not perceptible to himself. Ipec. soon removed this. (Med. Adv., xxvi. 110). J. R. Haynes (quoted B. J. H., xxxvii. 203) uses Ipec. as an antidote to the Opium and Morphia habit. He gives five drops of Ipec. Ø for every grain of Morphia (or its equivalent in Opium) which the patient has been accustomed to take. When a definite sequence is observed in the order of occurrence of symptoms this is of great practical importance. Woodward (Hahn. Adv., May, 1900, p. 278) has noted in twenty-three provers the symptoms of Ipec. develop in this order: (1) Gastric; (2) Respiratory; (3) Spinal; (4) Genito-urinary; (5) Cutaneous. In several instances, however, the cutaneous symptoms appeared before the genito-urinary. Owing to its immediate expulsive effect, given internally, upon the mucous membrane, its influence upon the skin has not been sufficiently considered. Mixed with oil, powdered Ipec. has been used to vesicate the skin; and, diluted, the tincture is used for the bites of insects, bee- and wasp-stings, etc. It produces violent irritation of the skin, and between the acts of vomiting an uncontrollable desire to scratch is often felt in those under the influence of material doses. Cooper cured an immense uterine fibroid where persistent painful irritation of the skin with constant retching and vomiting, made worse by eating, constituted the prominent symptom. Frightful irritation inside and out, especially vaginal, with thick leucorrhoea, and a feeling of desperation, yields to Ipec. Ipec. has been used locally and internally for malignant pustule and anthrax, in which disease Dr. Edwin Muskett considers it specific (Alleg. Hom. Zeitung., No. 23, Dec., 1888). In certain forms of peripheral neuritis it deserves more consideration than has hitherto been allotted to it (Cooper). In consequence of its proved cholagogue action, it constitutes nowadays a very frequent constituent of allopathic pills. Ipec. has much of the sensitiveness of Chi.─There is < by touch. Over-sensitiveness to heat and cold. < In winter and dry weather. < In warm, moist wind (catarrh, asthma, etc.). Chill is < in warm room; by external heat. Summer heat or hot room = fainting. Drinking > chill. Cold water > spasmodic cough. Cold drinks or ice-creams = colic. < Periodically; by vomiting; by coughing; by suppression of eruptions. < From veal from rich food (pork, fat, pastry); from ices.; lemon-peel; raisins salads, < By eating. < From abuse of quinine. < By motion. > By rest; by pressure; by closing eyes. Ipec., according to Hahnemann, is a short-acting medicine. It is specially suited to stout persons of lax fibre; to fair people; to women and children to emphysematous persons; to persons who have a history of epistaxis or other blood-loss.

Relations.─Antidoted by: Arn., Ars., Chi., Nux, Tab. It antidotes: Alum., Apis, Arn., Ars., Chi., Copper fumes, Dulc., Fer., Lauro., Op., Sul. ac., Tab., Ant. t. Followed well by: Ars. (cholera infantum; debility; colds; croup; chills); Bell.; Bry.; Cadm. s. (yellow fever); Calc., Cham., Chi., Cupr., Ign., Nux, Pho., Puls., Sep., Sul., Ant. t., Tab., Ver. Complementary: Cupr. Compare: Cough after eating, Nux; (whilst eating and in open air, Calc.). One hand cold, the other hot, Chi., Dig., Pul., Mosch. Constant nausea, Cocc., Kali c., Sul., Ign., Acet. ac. Salivation lying down─Ipec.; (on lying down at night, Cham., Nux, Pho., Rhus). Grass-green stools, Arg. n. Expression of nausea, Aethus., Ant. t. Bruised headache, Ptel., Ver. (bruised feeling here and there in brain). Gastric disturbance from rich food, Pul. (but Pul. has foul tongue, Ipec. clean; with Pul. symptoms last only whilst food is in stomach, Ipec. when stomach is empty). Stomach relaxed, Staph., Lobel., Tab. Asthma, Cupr. (spasmodic element predominates), Lob. (with a weak sensation in epigastrium spreading up into chest. Whooping-cough with rigidity, Cina (clucking sound down oesophagus as child comes out of paroxysm; grinds teeth), Cupr. (spasms of flexors predominate). Vomiting, Ant. t. (Ipec. has more nausea, Ant. t. more vomiting and retching; Ipec. has clean or slightly-coated tongue, Ant. t. thickly-coated white; both have vomiting after a meal, after acids and after coughing). Pains fly from left to right. Lach. (side to side, Act. r.; right to left, Lyc.; with nausea, Ipec.). Chest affections from retrocession of measles rash, Bry. Asthma, oedema, Linum n. Sweetish, bloody taste, Berb. (also bitter taste; Berb. mouth is pasty or sticky, Ipec. more generally clean; Berb. has dry mouth, Ipec. increase of saliva and smarting in mouth and tongue).

Causation.─Vexation and reserved displeasure. Injuries. Suppressed eruptions. Quinine. Morphia. Indigestible foods.

SYMPTOMS.

1. Mind.─Cannot endure the least noise.─Cries and howling (of children).─Anxiety and fear of death.─Moroseness, with contempt for everything.─Disdainful humour.─Desire for a number of things, without knowing exactly which.─Irritability, and disposition to be angry.─Ailments from mortification or vexation, with indignation.─Impatience.─Slowness of conception.

2. Head.─Vertigo when walking, and when turning round, with tottering and staggering.─Pain, as of a bruise, in all the bones of the head, as far as the root of the tongue (with nausea and vomiting).─Headache as of a bruise of the brain and skull, which pierces through all the cranial bones into roots of teeth, with nausea.─As if brain compressed.─Attacks of headache, with nausea and vomiting.─Tearing in the forehead, excited or aggravated by being touched.─Lancinating headache, with heaviness of the head.─Stitches in the vertex (or forehead).─Painful pressure on the forehead.─Pain in the occiput and nape of the neck.─Hydrocephaloid.

3. Eyes.─Eyes red and inflamed.─Neuralgia of eyes, esp. r., extended to nose and mouth; in evening biting and pressure in eyes; he was awakened between 2 and 3 a.m. by tearing pains in eyes, esp. r., radiating to forehead and driving him out of bed, < from strong light, accompanied by chilliness, heat, sweat.─Eyelids closed, painful expression of face; the pillow was soaked with tears which flowed freely on opening r. eye.─Twitching of l. upper lid with three black spots before sight on lifting lid.─Scrofulous ophthalmia, pain in forehead and temples, photophobia and corneal ulceration.─Conjunctiva rose-coloured; cornea opaque; sight gone from r. eye, could not read, evening, from being dazzled by candle-light, which appeared multiplied five or six times; next morning fiery iridescent rings before l. eye, which had been less affected.─Humour in the corners of the eyes.─Trembling of the eyelids.─Twitching of the eyelids.─Hardened mucus in the external canthi.─Pupils dilated.─Confused sight.

4. Ears.─Coldness and chilliness of the ears (during the febrile heat).

5. Nose.─Epistaxis.─Loss of smell.─Coryza, with stoppage of the nose.

6. Face.─Pale, earthy, or yellowish colour of the face, which is bloated, with livid circles round the eyes.─Convulsive startings of the muscles of the face.─Lips covered with small aphthae and eruptions.─Rash in the face.─Fine branny eruption on face, with or without irritation.─Pityriasis.─Pain, as from excoriation, in the lips.─Convulsive startings of the lips.─Redness of the skin round the mouth.

7. Teeth.─Odontalgia by fits, as if a tooth were being extracted.─Toothache > while eating; < afternoon and night.─Toothache < by day; pain every few minutes with a jerk radiating into r. temple and nose, as if tooth being extracted.─The neuralgic pains of Ipec. and of Viol. od. often make for r. temple (Cooper).─Dentition.

8. Mouth.─Painful sensibility of all parts of the mouth.─Smarting in mouth and on (margins of) tongue.─Copious secretion of saliva.─Constantly obliged to swallow saliva.─Saliva runs from mouth on lying down.─Tongue: clean; white or yellow; pale.

9. Throat.─Sore throat, during deglutition, as from swelling of the pharynx.─Difficult deglutition, as from paralysis of the tongue and of the gullet.─Spasmodic contractive sensation in the throat.─Fauces, stinging, rough, sore, and dry.

10. Appetite.─Insipid and clammy, or bitter taste, esp. in the morning.─Sweetish taste, as of blood in the mouth.─Desire only for delicacies and things sweetened with sugar.─Want of appetite; the stomach feels relaxed.─Bad effects from eating pork, veal, etc.─Gastric catarrh from indigestible food, or from ice-cold things.─Adipsia.─Beer has an insipid taste.─Tobacco smoke is nauseous, and causes vomiting.─Great repugnance and dislike to all food.─Water-brash.

11. Stomach.─Nausea, as if proceeding from the stomach, with copious salivation, violent itching in the skin, and empty risings.─Retching, esp. after drinking anything cold, or after smoking.─Vomiting of drink, and of undigested food; or else of bilious, greenish, or acid, or mucous, gelatinous matter, sometimes immediately after a meal.─Vomiting of blood.─Vomiting, with sweat, heat, fetid breath, and thirst.─Vomiting with diarrhoea.─Vomiting on stooping.─Vomiting of black matter, like pitch.─Sensation of excessive uneasiness in the stomach and epigastrium.─Horrid, indescribable pain and sick feeling in the stomach.─Sensation, as if the stomach were empty and flaccid.─Swelling in the region of the stomach.─Pinching round the epigastrium and in the region of the hypochondria.─Pressure on the stomach with vomiting.

12. Abdomen.─Cutting and pinching in the abdomen (as from a hand, each finger sharply pressing into intestines), < in the highest degree by movement, > by repose.─Pinching pain in both hypochondria, and in region of pit of stomach.─Pain, as from excoriation in the abdomen.─Colic, with agitation, tossing, and cries (in children).─Colic, with cramp-like pains.─Incisive pains, in the umbilical region, with shuddering.─Flatulent colic, with frequent diarrhoeic stools.─Colic of strangulated hernia.

13. Stool and Anus.─Loose evacuations, like matter in a state of fermentation (like yeast).─Obstinate diarrhoea.─Loose evacuations, greenish, or yellow- (lemon-) coloured, of a putrid smell, or sanguineous, bilious, and mucous.─Stools: grassy-green; of white mucus.─Loose serous evacuations.─Diarrhoea, with nausea, colic (and vomiting).─Autumnal diarrhoea; much griping about the navel.─Diarrhoea of children inclining to dysentery.─Dysenteric evacuations, with white flocks, and followed by tenesmus.─Evacuation of black matter like pitch.─Haemorrhoids bleed profusely.─Itching of anus.

14. Urinary Organs.─Turbid urine, with sediment like brick-dust.─Red and scanty urine.─Unsuccessful urging to urinate.─Sanguineous urine, with pains in the region of the bladder, and of the navel, burning sensation in the urethra, inclination to vomit, and pain in the loins and in the pit of the stomach.─Discharge of pus from the urethra, with biting pain.

16. Female Sexual Organs.─Troublesome sensation, as of bearing down towards the genital parts, and towards the anus.─Menstruation too early and too profuse.─Metrorrhagia, with discharge of bright red and coagulated blood, with oppressed breathing.─Metrorrhagia, much depression and pain in r. half of head; soreness about womb and pain in l. hip and back; weight across forehead, and phlegm in back of throat, causing sickness; skin yellowish and very irritable, dark round eyes (cured).─Steady flow of bright red blood after confinement.─In labour and threatened miscarriage pains fly from l. to r., with nausea.─Catamenia premature, and too thick.─Stitches from navel to uterus.

17. Respiratory Organs.─Cough, esp. at night, with painful shocks in the head and stomach, and with loathing, retching, and vomiting.─Cough catching the breath, even to suffocation; during the attacks the child gets quite stiff, its face blue. It is excited by a contractive tickling sensation extending from upper part of larynx to lowest part of bronchial tubes; < on walking in cold air; on retiring; in morning and evening; on taking a deep breath. Accompanied by cold, as if the navel would be torn out; pains in abdomen like strangury; heat in head and face. The cough causes vomiting without nausea.─Rattling noise in the bronchial tubes when drawing breath.─Dry cough, excited by a contractive tickling in the larynx (particularly in the upper part), extending to the extremity of the bronchia, esp. when lying on l. side.─Cough, which resembles whooping-cough, with bleeding from the nose and mouth, and vomiting of food.─Cough, with spitting of blood, provoked by the least effort.─Spasmodic cough, dry, shaking, with fits of suffocation, stiffness of the body, and bluish face.─Cough as from vapour of sulphur, with expectoration of blood with mucus in the morning.─Suffocative cough in the evening; continuous cough with perspiration on the forehead, shocks in the head, retching and vomiting.─Anxious and short respiration.─Quick, anxious breathing.─The breath smells fetid.─Suffocative attacks in the room; > in the open air.─Whooping-cough; every fresh attack sets in with a long-drawn, difficult, howling, sighing inspiration.─Spasmodic asthma, with contraction of the larynx, and panting respiration.─Sighing respiration.

18. Chest.─Oppression of the chest, and shortness of breath, as if dust had been inhaled.─Loss of breath on the least movement.─Spasms in the chest.─Pain, as of excoriation in the chest.─Palpitation of the heart.─Red itching spots on the chest, with burning after scratching.

20. Neck and Back.─Swelling and suppuration in the throat-pit.─Cramp pain between the scapulae during motion.─Tetanic stiffness and bending of the back, backwards or forwards.

22. Upper Limbs.─Coldness of one hand while the other is hot.

23. Lower Limbs.─Convulsive startings of the legs and of the feet (not in the upper limbs).─Pain, as from dislocation, in the hip-joint, when sitting.─Nocturnal cramps in the muscles of the thigh, with lumps in the thighs.─Violent itching in the calves of the legs.─Ulcers, with black bases on the legs, and on the foot.

24. Generalities.─Pain, as from a bruise, in all the bones.─Tingling in the joints, as when numbed.─Fits of uneasiness, with dislike to all food, and excessive and sudden debility.─Nausea, with almost all ailments.─Bleeding from different organs; haemorrhages from all the orifices of the body (bright red).─Too great sensibility to cold and to heat.─Tetanus; spasms and convulsions of different kinds; sometimes with bending backwards of the head, and distortion of the features; or with loss of consciousness; face pale and bloated, eyes half closed, convulsive movements of the muscles of the face, lips, eyelids, and limbs, at times with cries, inclination to vomit, and rattling of mucus in the chest.─In morning, on awaking, anxious agitation of the blood, as if he had been subjected to a great heat, or had had profuse perspiration, or had awakened out of an anxious dream, though the skin was neither hot nor moist; at same time a heaviness in head as if brain were compressed.─Dropsy of internal parts.─Chlorosis, menses scanty; skin and mucous surfaces pale, anaemic.─Excessive emaciation.

25. Skin.─Miliary eruptions, violent itching in the skin (of the thighs and of the arms).─During the nausea the patient is forced to scratch himself, until relieved by vomiting.─Rash (in lying-in women); suppressed rash.

26. Sleep.─Sleeplessness.─Sleep, with the eyes half open.─Agitated sleep, with groans.─During sleep, starting of the limbs.─Frightful dreams, with frequent starts and terror during sleep.

27. Fever.─Pulse very frequent, but at times scarcely perceptible.─Shuddering, with coldness in the limbs and in the face.─Chill of short duration and soon changing to heat.─Coldness, esp. in the hands and feet, with cold and copious perspiration on those parts.─External chilliness with internal heat.─Aggravation of the shivering from external heat.─Internal chilliness, as if under the skin, < from heat.─Before the shiverings, uneasiness, stretching, and lassitude, with cold sweat on the forehead, or coldness, or shivering, in the ears.─Sudden heat in a room, with sweat and vertigo.─Thirst during the shivering or coldness.─Fever, manifesting itself by much shivering, with little heat, or by much heat with little shivering; or with nausea, vomiting, and other gastric symptoms, tongue clean or loaded, and constrictive oppression of the chest.─Fever in the evening, with great inquietude, dry and troublesome heat, burning in the palms of the hands, and nocturnal sweat.─After a short chill dry heat, with parchment-like skin.─During the heat no thirst.─Perspiration smelling sour (with turbid urine).─Intermittent fever; nausea and vomiting predominate; slight chills are followed by much heat, with thirst and no subsequent perspiration, consequent upon the abuse of quinine; slight chilliness without thirst, afterwards violent heat, with thirst, nausea and vomiting, dyspnoea, stitches in the chest, finally copious perspiration.─Damp coldness of the hands and feet.

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

Ipecac (Rubiaceae)

Adapted to cases where the gastric symptoms predominate (Ant. c., Puls.); tongue clean or slightly coated. In all diseases with constant and continual nausea. Nausea: with profuse saliva; vomiting of white, glairy mucus in large quantities, without relief; sleepy afterwards; worse from stooping; the primary effects of tobacco; of pregnancy. Stomach: feels relaxed, as if hanging down (Ign., Staph.); clutching, squeezing, griping, as from a hand, each finger sharply pressing into intestines; worse from motion. Flatulent, cutting colic about umbilicus. Stool: grassy-green; of white mucus (Colch.); bloody; fermented, foamy, slimy, like frothy molasses. Autumnal dysentry; cold nights, after hot days (Colch., Merc.). Asiatic cholera, first symptoms, where nausea and vomiting predominate (Colch.). Haemorrhage: active or passive, bright-red from all the orifices of the body (Erig., Mill.); uterine, profuse, clotted; heavy, oppressed breathing during; stitches from navel to uterus. Cutting pains across abdomen from left to right (Lach., - from right to left, Lyc.). Cough: dry spasmodic, constricted, asthmatic. Difficult breathing from least exercise; violent dyspnoea, with wheezing and anxiety about the stomach. Whooping-cough: child loses breath, turns pale, stiff and blue; strangling, with gagging and vomiting of mucus; bleeding from nose or mouth (Indigo). Cough, with rattling of mucus in bronchi when inspiring (Ant. t.); threatened suffocation from mucus. Pains as if bones were all torn to pieces (as if broken, Eup.). Intermittent fever: in beginning of irregular cases; with nausea, or from gastric disturbance; after abuse of, or suppression from quinine. Intermittent dyspepsia, every other day at same hour; fever, with persistent nausea. Oversensitive to heat and cold.

Relations. - Complementary: Cuprum. Is followed well: by, Ars. in influenza, chills, croup, debility, cholera infantum; by Ant. t., in foreign bodies in larynx. Similar: to, Puls., Ant. c., in gastric troubles.

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

Leaders In Homoeopathic Therapeutics, Eugene Beauharnais Nash

Persistent nausea, which nothing relieves, in many complaints.

Headache as if bruised, all through the bones of the head, down into root of tongue, with nausea.

Stools as if fermented, or as green as grass, with colic and nausea.

Haemorrhages from uterus; profuse, bright blood and heavy breading with nausea.

Spasmodic, or asthmatic cough; great depression and wheezing breading; child becomes rigid and turns blue.

Backache, short chill, long fever, heat usually with thirst; raging headache, nausea; and sweat last; nausea during pyrexia.

Better than Quinine, in intermittents, or after its abuse, the symptoms agreeing.

* * * * *

Ipecacuanha leads all the remedies for nausea. Any complaint accompanied with persistent nausea, the patient not being at all relieved by vomiting, just as sick after as before-this is what we mean by persistent nausea. This should at once call attention to this remedy. It is often found in connection with gastric troubles from dietetic errors, and the choice will sometimes be between Ipecacuanha and Pulsatilla, because both are useful in gastric disturbances caused by indulgence in mixed diet – pastry, ice-cream, pork, fatty food, etc. Pulsatilla may be considered the better, while the food is in the stomach. Ipecacuanha after it is out, but the nausea persists notwithstanding.

Again, with Pulsatilla the tongue is often coated, like Antimonium crudum, while with Ipecacuanha there may be a slight coating, or the tongue may be perfectly clean. This vomiting with clean tongue, however, is not an infallible indication for Ipecacuanha, for we sometimes find it in connection with worm symptoms, where Cina has it just as prominently, and is the remedy. Digitalis also has it in heart disease. Ipecacuanha affects the whole intestinal tract. One very characteristic symptom is that the stomach and bowels feel as if relaxed and hanging down.

There are three kinds of looseness of the bowels, or rather three characteristic stools:

1. Fermented stools-foamy, like yeast.

2. Grass-green stools – mucous or watery.

3. Slimy stools – dysenteric, with more or less blood.

All these stools are found very often in children, especially in summer time, often as a consequence of overeating or wrong eating, when a dose of Ipecacuanha 200th will set matters to rights, and prevent the little patient from running into so-called cholera-infantum or enterocolitis, which often becomes a very serious and obstinate affection. The characteristic nausea is a sure indication.

We will also find this nausea present, where this remedy is the "proper caper", in headaches. Headache, as if bruised, all through the bones of the head, and down into the root of the tongue. This kind of headache may be of rheumatic origin, but the nausea is there just the same, if Ipecacuanha is to cure. Then we have a sick headache of gastric origin, the nausea beginning before the pain in the head, and continuing all through. In what seems to be hydrocephaloid with this nausea, Ipecacuanha has often cleared up the whole case in a few hours.

Again, we find the nausea accompanying the cough in the affections of the respiratory organs. Also in the haemorrhages and in the fevers in which it is often indicated. In short, we cannot do better than to use Hering's expression: "Nausea, distressing, constant, with almost all complaints, as if from the stomach, with empty eructations, accumulation of much saliva, qualmishness and efforts to vomit", nothing relieves.

During the nausea, the face is generally pale, eyes sunken, with blue margins, and often there is more or less twitching of face and lips, and sleepiness after vomiting. We have a great many remedies that are powerful emetics, like Antimonium tartaricum, Zinc sulphate, Lobelia and Apomorphine; but, so far as I know, the nausea is not so persistent, nor is it found in connection with so many other affections. Of course, no single symptom, however strong, would justify a prescription, if there were other symptoms just as strong in the same case.

For instance, if there were burning in the stomach, intense thirst, but could not drink, great restlessness and prostration, we would think of Arsenicum album, and it is often the best remedy to follow Ipecac., if the case goes from bad to worse.

Ipecacuanha affects the mucous lining of the respiratory organs, almost as prominently as it does that of the alimentary tract.

There is a great accumulation of mucus, which loads up the air cells and bronchi, until there seems to be great danger of suffocation. Note the symptoms:

"Violent degree of dyspnoea, with wheezing and great weight and anxiety about the proecordia." (Antimon. tart., coarse rattling.) "Threatened suffocation from accumulation of mucus."

This excessive accumulation of mucus in the air passages seems to excite spasm like a foreign body, and an asthma, or spasmodic cough, or both together, ensue. But the spasmodic cough and asthma do not seem to all depend upon accumulation of mucus, for Ipecacuanha is often our best remedy in the first stage of both asthma and whooping cough, before the stage when the mucus is present.

Again, "Suffocating cough, whereby the child becomes quite stiff and blue in the face".

"Whooping cough, with nosebleed (Indigo), bleeding from the mouth, vomiting, loses breath, turns pale or blue, and becomes rigid."

Infantile pneumonia. with chest loaded with mucus, rapid, wheezing respiration, surface blue, face pale, finds a very effectual remedy in Ipecacuanha. Old people with emphysema form chronic asthma are also > by Ipecac. So that we might narrow down the respiratory troubles to two conditions:

1st, Those in which excessive accumulation of mucus characterized the case.

2nd, Those in which spasm was the characteristic feature.

Of course, all the symptoms must be taken into consideration, in order to differentiate between Ipecacuanha and other remedies having the same objective states and conditions.

The control that this remedy has over haemorrhages deserves honorable mention It has haemorrhages from the nose, stomach, rectum, womb, lungs and bladder; from all the orifices of the body. So does Crotalus, but the blood in Ipecacuanha is bright red, not decomposed. Sulphuric acid also has haemorrhages from all the outlets of the body, but the other attending symptoms are different. With Ipecacuanha, the haemorrhages are active, profuse, bright red. It is a better remedy than Secale ever was or can be, for post-partum haemorrhages, and it is not necessary to use it in large and poisonous doses, for it will stop them in the 200th potency, and is quicker in its action than Secale. Let us notice a few remedies for haemorrhages:

Ipecacuanha. Bright red, profuse, with heavy breathing and nausea.

Aconitum. Active, bright, with great fear and anxiety.

Arnica. From injuries, bodily fatigue, physical exertion.

Belladonna. Blood hot, throbbing carotid, congestion to head.

Carbo vegetabilis. Almost entire collapse, pale face, wants to be fanned.

China. Great loss of blood, ringing in ears, faintness.

Crocus. Blood clots in long, dark strings.

Ferrum. Partly fluid, partly solid, very red face, or red and pale alternately.

Hyoscyamus. Delirium, and jerking, and twitching of muscles.

Lachesis. Blood decomposed, sediment like charred straw.

Crotalus, Elaps and Sulphuric acid. Black fluid blood, the first and last from all outlets.

Nitric acid. Active haemorrhages of bright blood.

Phosphorus. Profuse and persistent, even from small wounds and tumors.

Platinum. Partly fluid, acid partly hard black clots.

Pulsatilla. Intermittent haemorrhages.

Secale. Passive flow in feeble, cachectic women.

Sulphur. In psoric constitutions; other remedies fail.

Other remedies and indications might be added here, but haemorrhage is only one symptom, and never alone furnishes a reliable indication for any remedy. But Ipecacuanha is one of the best if indicated.

Ipecacuanha is a well-known intermittent fever remedy in our school. Jahr recommends it in the beginning of all cases, unless there are special indications for some other remedy, and says "By pursuing this course I have cured many cases of fever and ague by the first prescription, thus saving myself a good deal of unnecessary seeking and comparing". Whatever may be said in condemnation of this loose prescribing, it is certainly preferable to the inevitable Quinine prescription of the old school, and some self-styled homoeopaths, for the reason that it will cure more cases than Quinine, and do infinitely less harm. Ipecac. can cure more cases than Quinine, but both can cure the case to which they are homoeopathic, and that in the potentized form of the drug. We have such clear-cut indications for the use of many remedies that we need not fail once where the allopaths do twenty times, with their indiscriminate Quinine treatment.

The whole case generally revolves around one to three guiding symptoms, for instance: Ipecac. The persistent nausea in one or all stages.

Arsenicum alb. Irregularly developed paroxysm; thirst intense during heat, for small quantities.

Eupator. perf. Bone pains; vomits bile at end of chill, 7 to 9 A. M.

Ignatia. Chill, with red face, > by external heat: frequent sighing.

Capsicum. Chill begins between shoulder blades and spreads.

Nux vomica. During heat can't uncover in least, without chill.

Nat. Mur. Chill 10 to 11 A. M.; bursting headache during heat; sweat >; after Quinine.

Rhus tox. Cough in chill; restless and dry tongue in heat; tossing about.

Podophyllum. Great loquacity during chill and heat; jaundice.

Antimonium tart. Great sleepiness during heat and sweat, with pale face.

These characteristics are genuine and reliable, and many more might be added if we had time and space, but they can all be found in H C Allen's work on Fevers. They show how different the remedies, and how particular the true prescriber must be, when selecting his remedy for this, as well as other diseases. Remittents also often come under the control of this remedy.