By Dr. Stauffer, Munich

From a very interesting article on this subject we excerpt the following cases which will prove of interest:

I.    A lady,, thirty years of age, noticed a year and nine months ago that catarrh of the stomach was setting in, which slowly grew worse; she was under medical treatment and was treated for some time with rinsing out the stomach, but without result Later on the treatment was discontinued, not was there any more dieting. In March, 1904, owing to the aggravation of her troubles, Pepsin, Muriatic acid and? Quinine were prescribed, the pains continued to increase, and she was especially troubled with heartburn. Then pregnancy supervened and since then her stomach troubles have been worse, she can only bear the smallest quantity of any food. There is aversion to food and drink, especially to meat. Alcoholic liquors and coffee cause a decided aggravation; she can not bear fruit. Much vomiting and thence increase of her debility. Since her treatments so far with water from Carlsbad and dieting availed nothing. I undertook her treatment on July 18, 1904.

     The lady was much debilitated, emaciated and anaemic, pregnant in the fourth month. The organs were all healthy except the stomach and the intestines. Her ailments were the following. The first breakfast, taken in bed, is generally borne well, but after the other meals, even if little is eaten and only such things as are easily digested, there is nausea, salivation, and frequently vomiting of the ingest a, followed by relief; aversion to food and drink, constriction of the o esophagus at the mere thought of food cramps in the stomach; motion and excitement aggravated he state even to swooning. Every day there are severe pains in the stomach and the abdomen from the accumulation of flatus there is a most stubborn constipation, on account of which she has been taking Rhubarb up to 8 g. a day. After stools there is a violent, painful constriction about the anus. From 10 a.m. to 4 p.m. she has severe pains in the occiput, which extend to the forehead. The renal region is very painful to the touch; now and then there are neither external swellings in the region; no albumen nor sugar in the urine. The physicians had explained the swelling as a chronic inflammation of the connective tissue about the kidney. There is also severe tearing toward the small of the back and the coccyx, radiating into the pelvis; these were explained as due to chronic inflammation of the ovaries on both sides; cold water compresses had been used to counteract this. Flushes of heat, tendency to palpitation of the heart; feverish temperatures often rise to 1010 prescription; cocculus 6, three drops, three times a day.

July 20, 1904. There has been no return of the vomiting and the cramps; there is a slight catarrh of the bladder. Cocculus is continued in alternation with Pulstilla.

July 31. The improvement progresses, the catarrh of the bladder has disappeared. The pains in the occiput have not returned. The appetite is better; there is no more aversion to food. The general state of health is considerably better. The stool is still defective and the flatulence is the same. Lavements with warm water. Cocculus 6 is continued.

August 15. Owing to periodical pains resembling labor pains where was ordered to bed for a few days. Urine is clear when discharged, but later there is copious sediment of uric acid. The pains in the renal region and in the small of the back are considerably better. Her sleep is good. Cocculus 12.

August 25. The improvement progresses, she feels stronger and healthier, the appetite is good, the labor pains, the cramps, and the headache have disappeared; cocculus 12, three times a day, is continued.

 November 22. The pregnancy takes its normal course with occasional troubles in the intestines, as the stool is still not regulated; no other medicines than Cocculus were prescribed. Lately even this remedy was only given when pains or troubles in the stomach threatened. Then it always gave an instant relief. The family then moved to another town, from which I was informed in March of this year that the mother was delivered of a vigorous and healthy child. The health of the mother, as I was informed, was excellent. The stool has improved since the birth of the child, so that there is a spontaneous stool every two to three days, although with some trouble. Platina, which I prescribed, or if necessary, some other remedy will also remove this last symptom.

     This case was a pronounced cocculus case, wherefore I preferred not to give any inter venting remedy, excepting Pulsatilla. The symptoms in the bladder may be ascribed to the metabolic changes caused by the remedy. The Perinephritis, which was supposed by the one party, and the oophoritis diagnosed by another party may naturally be explained as having been spinal irritation. There was not a pronounced case of hypermesis gravidarum, as the stomach troubles for the most part existed already before pregnancy, since nothing objective could be discovered in the stomach, the symptoms were only to be viewed as nervous irritations. The supervening pregnancy no doubt considerably aggravated the gastric symptoms. For the rest, however, Cocculus may very well be used in hyperemesis gravidarum with good success, whenever the other nervous symptoms point to it, since this ailment is a reflex symptom from the brain, or an irritation of the vegetative nervous system quite similar to seasickness. A change in the potency from the 6 to the 12 seemed to be indicated, since in consequence of the resolved reaction, which was too strong, the pains resembling labor-pains appeared, reminding one of a threatened abortion, the downward pressure of the uric acid or with the disorderly stools. There was no noticeable change in the favorable action on the stomach troubles and the spinal irritation when the potency was changed.

II.      The second patient was a lady thirty-two years old. I saw her first in the commencement of March, 1904. Before that she had been treated by various professors and specialists. The patient was sitting in bed with her limbs closely drawn up; she could not turn her head owing to the violent pain in the occiput and in the back of her neck, every movement causing a severe aggravation of the pains; she could not even move her eyes, and in consequence there was something staring in her eyes, and a lack of expression. There was a high degree of anaemia, since she could take hardly any nourishment and could not sleep at all. This state had continued for three and a half months, and no treatment had been of any use. There was also a great sensitiveness of the spinal column; great weakness and paralysis in the whole of the back, tearing and lancinations alternating in the legs. She also especially complained of chilliness in the back, her legs also were always ice-cold, and there was a sensation as if there were needles of ice under the skin. The sensory was benumbed, the memory very bad, and great irritability, together with indifference; the patient complained also that she always felt as if reeling from intoxication. This state had come upon her very suddenly, without visible cause and yet proved very stubborn. There was no cause that could be adduced for her ailment. Her grandfather on the mother’s side had long been paralyzed, owing to a paralytic stroke. One party diagnosed an inflammatory process in the cerebellum; a tumor had also been thought of. One of the celebrated authorities had shortly pronounced the whole matter to be hysteria; but as the case was further observed, not a single hysterical symptom could be seen. The whole case was so complicated that I could form no diagnosis. On the basis of the symptoms I gave her Agaricus 6, and was considering Zincum. But Agaricus did not produce the slightest improvement in the succeeding days, though I had expected a useful action. In completing the anamnesis, I found out that the patient when twelve years of age had suffered from abdominal convulsions, had commenced menstruatingh with thirteen years, always with cramps; later on she had a retention of urine, lasting for six days; she had married without having quite recovered from this affection of the bladder. Four weeks after her marriage she had a severe tedious inflammation of the abdomen. Then there was an abortion caused by an incautious examination by a gynecologist; after this she had for three years in succession every year a child. Then preservative remedies were used; four years later there was a fourth normal birth, followed by a parametritis, and nest year an abortion. After the next three births there appeared, with the utmost punctuality as to day and hour, on the ninth day after every menstruation a so-called perineal pain, which lasted only a few hours, but was so violent that the woman was always for a week as if she had been on the rack, and could not fully recover, before the painful menstruation would again set in. The menstruation was always long continued and copious. The nine days succeeding would then be tolerable, but her dread of the new attack she apprehended did not allow her to recuperate. The perineal pain began in the small of the back. Radiating towards the pelvis; it was convulsive with meteorism; the stool was omitted this day and the next; at times there followed a copious, sharp fluor albus. The back and the small of the back were extremely sensitive to the touch. Every movement aggravated the state, and the legs were afterwards as if paralyzed with the most varied paraesthesias. The pain in the occiput described above was accompanied with an intense vertigo, especially when sitting up, with nausea, vomituria and even vomiting of mucus and gall. For years before, it had been impossible for her to ride in a carriage or in a railroad car without attacks of vertigo and vomiting. Besides this she has an aversion to eating, and eating aggravates her troubles, but even more the use of alcoholic liquors.

      Based on these symptoms, I gave her Cocculus 4, three drops every two hours. This at first caused a violent aggravation. Then I asked her to take the remedy only three times a day; but it continued to cause aggravations. I then gave her Cocculus 8 and 16 D., Three times a day, three drops, and in the course of two weeks the pain in the occiput, the vertigo and the spinal irritation had pretty well disappeared. The lady now rides in the automobile and in the railroad cars without any trouble. The perineal pains have not left as yet; there was, indeed, for three times an intermission, and it has diminished in intensity, but he dysmenorrhoea has ceased. Later on several remedies were given against the perineal pain, especially Thuja, on account of a suspiciaon of a gonorrhoeal infection at the beginning of her marriage. Then also Nux vomica, Sulphur and Lycopodium were given; the latter proved so far the most useful remedy; also other remedies were tried. A gynaecologist thinks he has established an inflammation of the surrounding parts, and spoke of a surgical operation; but I felt myself compelled to dissuade from this as I could not find any urgent call for it. According to my opinion it was a nervous symptom, as seems to be indicated by its periodical appearance, as well as the great excitability of the patient. In all likelihood the use of the preservatives during sexual intercourse (a condom on the part of the husband) may be the cause; at least I have seen this symptom disappear in quite a similar case when the natural sexual intercourse was resumed. An additional pregnancy would probably make a change. The diagnosis in this case we can in conclusion draw with some certainty. There was neither a tumor nor hysteria, but merely a great degree of spinal irritation with its consequences the fundamental ailment may probably be found in the organs of the sexual region, either because a chronic inflammation there still continues, or that the sexual life of the woman suffered from a continuous disturbance through the preservative means employed. Cocculus in this case cured the consequences, but the primary ailment is manifestly beyond the reach of the remedy.