-
















CROTALUS HORRIDUS.
ITS ANALOGY TO
YELLOW FEVER,
MALIGNANT, BILIOUS, AND REMITTENT FEVERS.
DEMONSTRATED BY THE ACTION OF THE VENOM ON MAN
AND ANIMALS.
WITH AN ACCOUNT OF HUMIBOLDT'S PROPHYLACTIC INOCULATION OF THE
VENOM OF A SERPENT, AT HAVANA, CUBA.
BY C. NEIDHARD, M.D.,
LATE PROFESSOR OF CLINICAL MEDICINE IN THE HOM(EOPATHIC MEDICAL COLLEGE OF PENNSYLYANIA, ORDINARY AND CORRESPONDING MEMBER OF THE HOM(EOPATHIC SOCIETIES OF LEIPZIGO
PARIS, VIENNA, &C., &C.
SECOND EDITION, REVISED AND ENLARGED,
NEW-YORK:
WM. RADDE, No. 550 PEARL-STREET.
PHILADELPHIA: F. E. BOERICKE, 635 Arch-st.
Boston: OTIS CLAPP.-St. Louis: H. C. G. LUYTIES.-Cincinnati: SMITH & WORTHINGTON.-Detroit: E. A. LODGE, M.D.-Chicago: C. S. HALSEY.-Cleveland: BECKWITE &; Co.-Pitt"s
burg, Pa.: J. G. BACKOFEN & SON.-London, Eng.: H. TURNER & Co., No. 77T Fleet Street;
JAMES EPPs, No. 112 Great Russell Street.
1868.




Entered, according to Act of Congress, in the year 1860, by
WILLIAM RADDE,
In the Clerk's Office of the District Court of the United States for the Southern District of
New-York.
IGARY 1AD*I4d,
Book and Job Printer and Stereotyper;
Nos. 39 and 41 Centre-Street.




PREF ACE.
TnT following account of the Yellow Fever in Philadelphia,
during the year 1863, was written at the time of its occurrence. Some cases of Bilious Remittent Fever were added
subsequently. The facts seemed to me important enough to
be preserved in the archives of homceopathy.
My almost exclusive use of CROTALUS in the milder cases of
this otherwise formidable disease was involuntary. I prescribed it, again and again, because it was the only remedy
which seemed most promptly to subdue the symptoms of this
disease.
On comparing the pathogenetic effects of CROTALUS, from1
MURE, HERING, and JAHR, with the prominent phenomena of
Yellow Fever, the conviction cannot fail to impress itself
upon the reader's mind, as it did upon mine, that CROTALUS
is probably the principal, if not the only true homaeopathic
remedy, even in the more formidable cases of this disease.
This is farther corroborated by the prophylactic inoculation of the same agent, instituted by HUMBOLDT in the mili.
tary hospital at Havana. Farther experience in the South,
on a large and extended scale, will be required to confirm or
overthrow this supposition.
THE AUTHOR.




PREFACE TO THE SECOND EDITION.
IN this preface to his second edition, the author wishes to
draw the attention of the medical public to the remarkable
and exhaustive work of Dr. S. W. JIitcehell, on the venom of
the Crotalus Horridus, wherein his own views are fully confirined. Dr. Mitchell considers the eeect of the venlom of the
rattle-snake, and that of the Yellow Fever, on the hauman
body as almost identical. His views are the more to be credited as coining from an author who does not believe in the
efficacy of the poison, if internally administered, as mentioned
in the works of Fontana, Jeter, Burnett and others, as well
as the whole homoeopathic school.:Neither is he an advocate
of the homceopathic law of cure.
The candid inquirer after reading the observations of Dr.
Mitchell cannot fail of arriving at the conclusion, that the venom of the Crotalus is the true specific, or homneopathic
remedy in Yellow Fever, as well as in similar fevers. This
similarity manifests itself not merely by external symptoms,
(surface symptomatology) but by the deeper action on the
nervous centres and the blood. In other words, the symptoms
of the Yellow Fever poison, as well as those of the Crotalus
poisoning, may, according to the individuality of the person
afflicted, vary with this individuality; all drug as well as
natural diseases, most easily affecting the weakest organs;
but in their grand general features both poisons will be found
wonderfully analogous to each other.
Yellow Fever being only an aggravated form of Malignant
Bilious Fever, we have, for this reason, found Crotalus so
useful in the latter disease.




TABLE OF CONTENTS.
CHAPTER I.-Yellow Fever in Philadelphia during the Summer and Autumn
of 1853.
CHAPTER II.-Contagious or Non-contagious?
CHAPTER III.-Analysis of Symptoms.
CHAPTER IV.-Allopathic Treatment.
CHAPTER V.-Homceopathic Treatment.
CHAPTER VI.-Comparison of the Symptoms of Yellow Fever with the
Pathogenetic Symptoms of Crotalus Horridus.
CHAPTER VII. —a. Some Cases of Malignant Remittent Fever.
b. Nine new Cases of Remittent Fever.
CHAPTER VIII.-Translation from Manzini's History of Humboldt's Prophylactic Inoculation of the virus of a Serpent, at Havana, Cuba.Conclusion.




NOTICES OF THE PRESS, &c.
This work undoubtedly calls for a special notice by the Homoeopathic Press,
as well as in consequence of its issuing from the able pen of one of our most
scientific and successful practitioners of homeopathy. as on account of the high
practical importance of its contents.  *  *  *"       *  To judge from these facts
there cannot, for all those that are familiar with the fundamental law of nature
in curing disease be any doubt, that Crotalus Horridus, if it is not the specific
for Yellow Fever and its kindred diseases  *::' must at least become the
most efficient means to reduce the deadly virulence of that malady.
We recommend Dr. Neidhard's work to the careful perusal of all that take
interest in the cause of humanity, medical science and human art particularly.
Almost every one may learn something by it, and our brethren of the old
school (supposing they were willing to learn), might by studying it, get a
glimpse of the truth, that the great principle of homceopathy, similia similibus
curantur, is an invariable law of nature, which even the most foolishly conducted
experiments (as was the case in the Military Hospital in Cuba) will bring to
light. —U. S. Journal of Homweopathy, Feb. 1860.
A valuable monograph upon a remedy which, relatively, is new to the profession. If the author be not altogether too sanguine, we may expect tile best
results to come of its general use by Western and Southern physicians in the
graver forms of bilious remittent fever, to say nothing of that scourge, the Yellow Fever, should it again prevail on our shores. He certainly makes out a
very good case, and it were worth our while to test the matter, and know if it
be possible, by such means, to cure a violent fever, which often lasts from five
to six weeks, in the short space of a fortnight. We append the table of contents
premising that Chapter VI. and VII. are more interesting than aught contained
in the Atlantic or Harper for November.-Medical Investigator, Chicago.
"Dr. Neidhard makes a comparison of the symptoms of Yellow Fever with
those produced by the bite of the rattlesnake (Crotalus Horridus), and, imperfect as is our knowledge of the pathogenetic effects of this virus, the disease
seems to be pretty well represented in its symptomatology, thus justifying his
belief, that Crotalus is truly homoeopathic in Yellow Fever.
It seems evident, that the inoculation produced a well-defined group of symptoms, closely resembling those of Yellow Fever, and we consider Dr. Neidhard
justified in pronouncing it a truly homexopathic remedy in the disease, and we can
understand his successful employment of it."-British Journal of Homrzeopathy,
Vol. 15, page 468




NOTICES OF THE PRESS.                        Vil
One of our most esteemed colleagues furnished his experience on a subject
which is of the greatest importance to suffering humanity, as well as medical
science.
From the copious extracts, which we have made from the work, it will be
seen, that it contains a rich material of the most interesting and important data,
well worthy of farther investigation. We recommend it therefore to all those
who are acquainted with the English language.
Dr. Neidhard's experience may not be sufficient to prove Crotalus, the specific remedy in Yellow Fever, but every practitioner must be indebted to our author for the valuable communication of his experience, by which the severe
sufferings of these diseases can be relieved much better, than was possible
hitherto by other remedies.-Neue Zeitschrift fiir Hornm. Klinik, von Dr. B.
ilirschel in Dresden.
The value of Crotalus in bilious or yellow fevers is confirmed by the extracts
from the works of Mure and Jahr, which show the symptoms of this poison as
strikingly similar to the phenomena of Yellow Fever and the more malignant
cases of bilious fever. *' *  The details are full of interest, not only to the
profession but to the general reader. Dr. N. deservedly enjoys a high reputation in this city. —Philadelphia Inquirer.
A Spanish translation of the work has appeared in Barcelona, and is for sale
in Havana, Cuba, at " Imprenta y Liberia de Dr. D. Andres Graupera, calle del
Obispo No. 113. The following is the Spanish Preface.
" Habiendo Negado a mis manos el interesante opusculo que publico el ano
pasado, en Nueva York, M. C. Neidhard, Doctor en Medicina, sobre la eficacia
del virus de la Serpiente caseabel (Crotalus Horridus) para la curacion de la
fiebre amarilla, he ereido que no podia menos de ser bien recibida su traduccion
al castellano por el PTiblico de esta grande Antilla, centro importante de tan
vasto comercio entre Europa y America, y a donde acuden tantos peninsulares
y estrangeros, y a donde acuderen muchos mas desde el momento en que se
ecuentre un especifico seguro contra la cruel enfermendad tropical que arrebeta
a una huesa prematura i tantos europeos, asi nacionales como estrangeros.
ANDRES GRAUPERA.




LITERATURE.
1. Wirkungen des Schlangengiftes, zum arztlichen Gebrauche vergleichend
zusammengestellt, durch Constantin Hering, Allentown, Pa.
2. Pathogenesies Bresilienne contenant trente-six experiences pures, par
B. Mure. Paris, a l'Institute Homeopathique. Rue de la Harpe, No.
93.
3. Mure's Materia Medica, or Provings of the principal animal and vegetable Poisons in the Brazilian Empire, translated from the French by
C. J. Hempel, M.D., Article Crotalus Cascarella. New-York, Wm.
Radde, 1854. Of this Crotalus, Dr. B. Mure says: " It is my belief,
that it affects the organism longer and more thoroughly than Lachesis
and will effect many cures, which had to remain incomplete under the
use of Lachesis.
4. Quarterly Summary of the Transactions of the college of Physicians of
Philadelphia, from August to October inclusive, 1853.
-5. Medical Examiner, 1853. Philadelphia.
6. Epidemic Yellow Fever and its Homoeopathic Treatment. By William
Holcombe, M.D., Natchez, Miss. 1853.
7. Letter to the Editor of the New Orleans Picayune on the Contagiousness
of the Disease, from Elgin, S. C.
8. Histoire de l'inoculation preservative de la fibvre jaune, pratiquie par
ordre de gouvernemnent Espagnol a l1'H6pital Militaire de la Havane.
RedigBe par Nicolas B. L. Manzini (Dr. Forli, Etats Romains), Docteur en Medicine de la facult6 de Paris, membre titulaire de la soci6te
medicale d'emulation de Paris, Medicin de l;association de bienfaisance
frangaise de la Havane. Paris: J. B. Balliere et fils, libraires de
l'academie imperiale de medicine, rue Hautefeuille, 19. 1860.
9. Smithsonian Contributions to Knowledge. Researches upon the venom
of the Rattlesnake, by S. Weir Mitchell, M.D., Lecturer on Physiology.
viii




THE NATURE OF CROTALUS-HORRIDUS.
To illustrate the nature of this poison in its connection
with yellow fever, we will detail the chief data of Dr. Mitchell's most interesting experiments and observations:
Fifteen drops of venom was the largest quantity Dr. M.
saw ejected from the mouth of the snake, by natural process.
After the first ejection had taken place, the snakes rarely
throw out more than from two to four drops.
The color of the venom varied from a pale emerald green
to orange and straw color. When the poison had remained
long in the gland, it was deeper in hue than when its ejection
followed rapidly upon its formation, In eight observations
on record the venom reddened litmus paper more or less distinctly. It was uniformly acid, and this reaction was coinmon to all specimens of the poison, whether moist or dry,
dark-colored or pale in tint.  The reaction of the mucous
membrane of the mouth was almost as consistently alkaline
as that of the venom was acid. It was found that litmus,
reddened by the venom, became blue again when left in the
serpent's jaws; but although the acid was neutralized, the
poisonous properties of the fluid remained unaltered.
According to Mitchell the venom of the rattlesnake is composed of
1. An albuminoid body. C~rotaline not coagulable by heat
of 2120 Fahrenheit.
2. An albuminoid compound, coagulable at 2120~.
3. A coloring matter and an undetermined substance; both
soluble in alcohol.
4. A trace of fatty matter.
5. Salts, chlorides, and phosphates.
In the numerous experiments made by the author, where the
exhausted venom gland was mixed with water and introduced
into the wounds of various animals, it was ascertained that
ix




X                   THE NATURE OF
the pigeons all escaped, except one; that the rabbit was also
unhurt; but the reed birds all died.
The reed bird is remarkably susceptible to Crotalus venom,
and will frequently die from a quantity of poison so minute,
that it would be hard to conceive of its power to destroy life,
had not the experiment actually been made. Thus half a
drop will often kill a reed bird in a minute or two, and oneeighth of a drop will prove fatal after a lapse of from two to
eight hours; so that it is probable that even a smaller quantity would be sufficient to destroy life.
The secretion in Crotalus from the gland is constantly acid,
and in the viper neutral, while the saliva of the parotid, in all
animals yet examined, is unchangeably alkaline.
Saliva is a secretion of rapid formation, and appropriated to
specific mechanical and chemical purposes within the economy;
-the venom fluid is slowly elaborated; slowly reproduced
when lost, and destined to no end within the body which produces it.
Its singular nature as a ferment; poisonous to other animals
as well as to its owner, constitutes a distinction which forbids
the physiologist to regard it, as, in any true sense, a salivary
secretion,. or its forming organ, as a salivary gland. Extensive experiments with chemical reagents, as well as with extremes of heat and cold, have unfolded the singular energy of
this poison, and the almost inconceivable tenacity with which
its powers are preserved.
The dried venom retained its potency after two years of
climatic changes; the fresh poison, although prone to partial
decomposition, would remain active after a sojourn of several
weeks in an atmosphere of 6.5~ to 70~ Fahrenheit.
Mixing the venom with water, and freezing it, and keeping
it for half an hour at 4 degrees above zero, did not in the
least diminish its power; nor did a temperature of 2120 F.
destroy its vitality.
In eight experiments Dr. M. has shown that,
1. The coagulum produced by heat is always innocent.
2. The supernatant fluid is uniformly poisonous. The cases
died with the usual rapidity.-A fact which leads us to infer
that the venom loses no power by being heated. The animals




CROTALUS-HORRIDUS.                 xi
which perished from the injection of the boiled venonm exhibited very trifling local evidences of the action of the poison.
Dr. M. is unable to offer any plausible explanation of this curious deficiency. (Were he a believer in the dynamic origin
of disease and action of remedies, he would be better able to
comprehend this phenomenon.)
The mingling of the venom with Alcohol, Sulphuric-acid,
Muriatic-ac., Ammonia, Chlorine-water, Iodine, Soda and Potassa, in a diluted or undiluted state, did not destroy the virulence of the venom.
When venom was mingled with certain of these agents,
such as Iodine in solution, Tannic-acid, &c., the constitutional symptoms declared themselves as usual in the pigeons
employed; but the local phenomenla were more or less wanting.
The Crotalus venom  has the power of preventing the gerinination of canary and mignionette seeds.
"On several occasions," I quote the words of Dr. AM., "I
had noticed the production of fungi in moist venom, long
kept upon my table, in an atmosphere of from 64~ to 70~ F."
"I have also observed in other specimens long kept, and
somewhat diluted, that after seven to ten days, the poison acquired an odor of a peculiar and very disgusting character. The
production of this animalized and indescribable stench, was
accompanied by the appearance of vibriones, and, a few days
later, of rotiferal and other minute forms of animalcular life.
The question was, what power yet remained in the venom
which had become the nidus of so much active vitality. I
tested it on animals, and still found it actively poisonous."
From the same work we gather the following interesting
data-particularly such phenomena as may have reference to
Yellow or Bilious Fevers.
"Both pigeons were enfeebled by the poison, and seemed
disposed to sleep. One of them sunk slowly, lower and lower,
until its head touched the table, when it rolled on its side.
In ten minutes, a pigeon, after it was struck on the back by
a small snake, fell into the usual stupor, with jerking, abrupt
respiration, &c. The bird became gradually weaker and
weaker, and died without convulsions, at the close of an hour




Xii                 THE NATURE OF
and a half. The pupils gradually contracted before death,
and suddenly dilated afterwards.
The tissues, for an inch or more around the wound, were
soaked with extravasated blood, which had even passed
through between the ribs, so as to stain the tissues behind the
intestines.
The heart was large and full of perfectly fluid blood.
" My chief reason for recording at length these cases," continues Dr. Mitchell, "is to show the great increase in the internal lesions which occurs, when the venom is long in killing
the animal."
Among these changes it was found, as a general rule, that
the blood was most affected, and least coagulable, the longer
death was delayed.
In two cases the dogs passed clay-colored stools.
So far as a fatal result is concerned, it seems to be indifferent, whether the bite takes place about the head and neck,
or in the limnbs.
This last observation is of great interest owing to the fact,
that the dog, a small terrier, survived very serious visceral
lesions, and lived during two days, with his blood in a condition of complete diffluence.
Twenty hours from the time of the poisoning) the dog was
found lying on his left side, having passed shiny and bloody
stools in abundance. At intervals he seemed to suffer much
from tenesmrus, but was so weak, that he stood up with difficulty. His gums were bleeding, a symptom I lhad seen before,
and his eyes were deeply injected. (The most characteristic
symptom of Yellow Fever, according to Manzini.)
Twenty-seven hours and a half after the time he was bitten,
his hind legs were twitching and the dysentery continued.
No clot was found in the blood. This case is doubly important because it shows how long the poisoning must continue
before the blood becomes diffluent.
Dr. Mitchell continues:
" The study of the envenomed blood has thus far taught us:
1st. That in animals which survive the poisoning for a time,
the blood is so altered as to render the fibrin incoagulable.
2d. Experiments in and out of the body have given proof,




CROTALUS- HORRIDUS.               X11i.that this change is gradual, and that the absence of coagulation is not due to checked formation of fibrin, but to alterations produced by the action of the venom in that fibrin which
already exists in the circulating blood.
3d. The influence thus exerted is of a putrefactive nature,
and imitates, in a few hours, the ordinary work of days of
change. It is probably even more rapid within the body, on
account of the higher temperature of the economy.
4th. The altered blood retains its power to absorb gases,
and thus to change its own color.
5th. The blood corpuscles are unaffected in acute poisoning
by Crotalus venom, and are rarely and doubtfully altered in
the inoot prolonged cases which result fatally.
6th. The contents of the blood globules of the guinea pig
can be made to crystallize, as is usual after other modes of
death.
Among the most constant and curious lesions in the cases
of secondary poisoning are the eccctymosis, which are found
on and in the viscera of' the chest and belly, most frequently
affecting the intestinal canal. They may and do occur in
any cavity and on any organ. These spots contain blood,
whose globules are more or less deformed, but still of dimenc
sions not less that usual. *  *       *X
Owing to the changes of the blood, or the tissues, or both,
extravasations are met with in the lungs, brain, kidneys, serous
membranes, intestines and heart. As a result we may have
functional derangement grafted on the main stem of the mar
lady and the accompaniments of bloody serum in the affectedcavities, bloody mucus in the intestinal canal, and bloody
urine in the bladder."
From the preceding experiments Dr. Mitchell naturally
arrives at the conclusion: " That the venom of Crotalus, like
that of other snakes is a septic, or putrefacient poison of as~
tounding energy; a view long held by toxicologists.
The rapid decomposition of the blood, and of the tissues'
locally acted upon by the venom, leaves no doubt upon the:
matter, and mnakes it apparent that an incipient putrefaction
of this nature may so affect the blood as to destroy its power
to clot, and perhaps, also, to nourish the tissues through which
it is urged."




XiV                   THE NATURE OF
The alterations thus brought about are, probably, the results of a continued fermentative change, which, begun by a
small amount of poison, is gradually made to involve in fatal
change, the whole mass of the circulating fluids. Like all
fermentations, however, the rapidity depends upon temperature, and on the amount of the primary ferment.
In one instance, a dog, struck by eight snakes died in eighteen minutes, and exhibited uncoagulable blood.
I am aware of no other case of loss of uncoagulable blood
so rapid.
It was rendered thus by the number of localities from which
the ferment attacked the system.
On the other hand, the frog, a small animal, receives the
same dose of venom as would have entered the tissues of a
larger animal; yet it resists the poison most remarkably, by
virtue of its powers as a cold-blooded creature, existing at the
temperature of the atmosphere itself.
The cause of death in chronic or secondary poisoning, may,
with propriety, then be referred to the incipient putrefactive
changes, which affect the blood, as well as to the continued
influence of the agencies, which first act to depress the heart's
action, and destroy nerve function.
Summing up what we have learnt of the acute forms of
poisoning, we may feel justified, according to Dr. Mitchell, in
concluding:
1st. That the heart becomes enfeebled shortly after the bite.
This is due to direct influence of the venom on this organ, and
not to the precedent loss of the respiratory funqtion. Notwithstanding the diminution of the cardial power, the heart
is usually in motion after the lungs cease to act, and its tissues
remain, for a time, locally irritable. The paralysis of the
heart is, therefore, not so complete as it is under the influence
of upas or corroval.
2d. That, in warm-blooded animals, artificial respiration
lengthens the life of the heart, but does not sustain it so long
as where the animal has died by woorara or decapitation.
3d. That in frogs the heart-acts continue after respiration
has ceased, and sometimes survive until the sensory nerves
and the nerve-centres are dead; the motor nerves alone re-;maining irritable.




CROTALUS-HORRIDUS.                  XV
4th. That in warm-blooded animals respiration ceases, owing to paralysis of the nerve-centres.
5th. That the sensory nerves, and the centres of nerve power,
in the medulla spinalis and the medulla oblongata, lose their
vitality before the eferent or motor nerves become affected.
6th. That the muscular system retains its irritability in the
cold-blooded animals, acutely poisoned, for a considerable
time after death.
7th. That the first effect of the venom being to depress the
vital energy of the heart and nerve centres, a resort to stimulants is clearly indicated, as the only rational mode of early
constitutional treatment.
Dr. S. Weir Mlitchell concludes this chapter on the action
of the venom on the tissues and fluids, from which we have
made such copious extracts with the following remarkable
sentences:
ANALOGY BETWEEN CROTALUS POISONING AND THE SYMPTOMS OF CERTAIN DISEASES.
I arm unwilling to leave this unsatisfactory, but necessary
part of my task, without calling attention to the singular likeness between the symptoms and lesions of Crotalus poisoning
and those of certain maladies, such as Yellow Fever.*  Iffor
a moment we lose sight of the local injection, and regard only
the symptoms which follow, and the tissue changes which ensue, the resemblance becomes still more striking.
In both diseases-for such they are-we have a class oJ cases
in wh/ich death seems to occur suddenly, and inexplicably, as
thoug/h caused by an overwhelming dose of the poison. In
both diseases these cases are marked by symptoms of profound
prostration, and in both the post-mortem revelations fail to explain the death. I have spoken, as an examples of Yellow
Fever, but similar instances are not wanting in Cholera, Typhoid and Typhus fevers, and in Scarlatina."
* This analogy has been noted by S. L. Mitchell, by Magendie, and by
Gaspard, who has also called attention to the resemblance between ordinary
putrefactive poisoning, such as arises from injection into the blood of decayed
animal substances, and the poisoning by venom.




xvi          THE NATURE OF CROTALUS-HORRIDUS.
"A second class of cases, both of CUrotalus poisoning, and of
Yellow Fever, survive the first shock of the malady, and then
begin to exhibit the train of symptoms, which terminates in
more or less complete degradation of the character of the blood,
varying remarkably among themselves, exhibiting, as it were,
prefirences for this, or that organ; all these maladies agree
in the destruction. of the fibrin of the blood, which these fatal
cases frequently exhibit.  Jn  Yellow Fever, the likeness to the
venom poisoning is most distinctly preserved, as we trace the
symptoms of both diseases to the point where the diffluent blood
leaks out into the mucous and serous cavities.  The yellowness
which characterizes many  Yellow Fever cases, I do not find
described as a current symptom of the venom malady, but it
is often mentioned as one of the accompaniments of the period
of recovery from the bite.*  It is indeed most probable, that if
small and repeated doses of venom were introduced, at intervals, into the body of an animal, a disease might be produced
even more nearly resembling the malady in question.  In the
parallel thus drawn, I have given the broad outlines of resemblance; nor was it to be expected that the minor details would
be alike. From a general and philosophic point of view, this
similarity is sufficiently striking to make me hope, that the
complete control of one such septic poison for experimental
use, may enable us, in future, to throw new light on those septic poisons of disease, of whose composition we know nothing
of, and whose very means of entering the body they destroy,
is as yet a mystery..
PHILADELPHIA,  1867.
* Jaundice, occasionally observed in Francej as an early symptom of viperbite, has been usually regarded as the Jaundice of fear; a cause which certainly cannot be invoked to account for the icterus, seen in the last stages of
the malady, caused by the venom.




THE EFFICACY OF CROTALUS HORRIDUS
IN
CHAPTER I.
YELLOW FEVBR IN PHILADELPHIA DURING THE SUMMER
AND AUTUMN OF 1853.
ON the 25th o? June, 1853, the bark MlJandarin sailed
from Cienfuegos, Cuba, for Philadelphia, all in good
health, with a cargo of sugar, molasses, and segars. Her
crew consisted of twelve men.
On arriving at the Lazaretto, July 12th, after a voyage
of seventeen days, she was visited by the officers of the
station; and, on oath, the captain reported cases of
small-pox and fever when he left, and that he had lost
two of his crew on the passage with fever. The statement of the Lazaretto physician was: "that the crew,
numbering ten souls, were examined, and reported to be
in good health; notwithstanding this it was considered
prudent that the bark should be detained until thoroughly ventilated, cleansed, and fumigated; the bedding




10                YELLOW FEVER
and clothing of the deceased sailors were destroyed, the
vessel was -whitewashed and fumigated in every part
with chloride of lime, the bedding of the crew aired,
and their clothing washed; she was detained an entire
day, and, before being allowed to proceed to Phiiadelphia, all on board were separately and minutely examined. All hands were on duty, and apparently free
from disease.
There was no development of disease of a n:alignant
type in the vicinity where this vessel lay, after the
strictest inquiry instituted by the port physician. Nor
had any of her sailors and laborers, employed in removing the cargo, been sick. But, when the cargo was out
of the vessel, a very offensive smell proceeded from her
hold; especially whenever her pumps agitated the bilgewater contained under the planks of the flooring, the
stench became intolerable.
The first case of suspicious fever was on the 19th of
July, the day before which the M/lndarin left her
position on Lombard-street wharf; a young man, whose
stand was at South-street wharf, sickened and died.
The next case was that of a captain, whose brig lay at
Lombard-street wharf, and who slept on board the brig,
and took his meals at the Champion House; he took
sick on the 20th. The next case was the son of Mr.
Koehler, who lived with his father at the Champion
House. The next was the keeper of the Red Bank
Ferry House, and his wife, in the same vicinity. Up to
July 27, there were seventeen cases, of which eleven
died. There were only eight of these cases which exhibited black vomit, and they all perished. In the month




IN PHILADELPHIA.               11
of August there were twenty-seven additional casespresenting, in all respects, evidence of yellow fevertwenty-three of which died.
In eleven of the thirty-four a post-mortem  was
made; in all of which the yellow or ochre-colored liver
was detected in whole or in part. In all of them the
"coffee-ground" fluid, or melanic blood, was found,
either in the stomach or intestines, with other evidence
of pernicious form of fever. The mortality was fearful, 80 per cent., or five to one of recoveries. The
disease still continued to prevail till the Ith of October,
when the last case occurred. During this period, of
eighty days, there were one hundred and seventy cases.
They included every variety of the disease, or those recognized in the nomenclature of yellow, malignant,
malignant remittent, pernicious, malignant bilious, and
typhus-icterodes fevers. One hundred and forty-seven
of these cases may be distinctly traced to the immediate
vicinity of the infected district, making South-street
wharf the centre..It was here the bark Mandcrin landed, which
brought the fever. Of the remainder, it is uncertain
where the fever was contracted. The ratio of mortality
was very large —out of 170 cases there were 128 deaths,
equal to 75 per cent.
This mortality must be ascribed to the virulence of
the miasmatic poison, for which the allopathic treatment hitherto pursued proved entirely inadequate. It
must not, however, be overlooked that there have been
other cases of fever in the infected locality, assuming a
less malignant form, which were not reported to the




12                 CONTAGIOUS
Board of Health. If these had been included in the
above estimate they would have diminished the ratio
of mortality. Among all the cases of malignant fever
that happened in 1853, in Philadelphia, of which we
have any record, there is not a single instance of its
occurrence among the colored population. This fact is
in accordance with a generally received observation
that the African race is much less susceptible to malarious influences than others. The late Dr. Campos, of
Norfolk, Va., averred that very fat people got over it
very well; while Dr. Antonio Leon Bilisoly, of the
same place, asserted the contrary.
CHAPTER II.
CONTAGIOUS OR NON-CONTAGIOUS?
THE non-contagiousness of the disease has been again
maintained in the epidemic of 1853, and it is averred
that, although many of the cases contracted by a visit to
the infected district were treatedfar beyond its limits, in
different parts of the city, in no one instance was the
disease communicated from one person to another. In
the Pennsylvania Hospital, twenty-four cases were
treated, and in wards surrounded by those who were
sick and convalescent from other diseases, and where
there was continual intercourse with the patients, still
not an individual in the house was attacked with the
fever. The like immunity was observed in the Blockley




OR 1NON-CONTAGIOUS?             13
Hospital, where, had the disease possessed contagious
qualities, it would very likely have spread among the
inmates.
Such is the specious reasoning of the non-contagionists,
who, at first sight, would seem to have all the facts and
reasoning in their favor. But these facts rather prove
too much. It is not denied that, at the wharf, or whereever the disease was in a concentrated form, many
persons were affected by it, either by clothes or by
contact.
Let us review the facts of some former epidemics. In
the year 1748, Dr. Lining, an eminent physician of
Charleston, S. C., gives a minute account of the yellow
fever of that year, and states that the disease had been
epidemic during several previous years in that town,
and that, in every instance, " it was easily traced to some
person who had lately arrived from the West India
Islands, where it was epidemical."  Dr. Chisholm, a
surgeon to the British forces in the West Indies, states
that this epidemic (1793) was brought by a ship to
Granada, one of the Windward Islands; that from this
island, to use his words, " it spread to the other
islands-to Jamaica, St. Domingo, and also to Philadelphia-by means of vessels on board which the infection
was retained by the clothes, more especially the woolen
jackets of the sailors."  He also further states "that
the disease appeared in several distinct and distant parts
of the island, whither the infection was carried by persons who had imprudently visited the infected houses
in the town."
The clothing of a victim to yellow fever in the West




14                 CONTAGIOUS
Indies was sent on and retained for a long time boxed
up tightly at the North, and, when finally opened, caused
the death, by yellow fever, of the person who took possession of the clothing. This happened in the interior
of New-Jersey (New-Orleans Picayune, 1854). We
must also here refer to the case of the family dwelling
upon the hills, back of Fort Adams, who had no
communication with the river, and among whom the
disease suddenly broke out in 1853, and which was referred to by the advocates of non-contagion. Upon
investigation, it turns out that this family had received
a sack of Rio coffee and a bale of goods from NewOrleans during the height of the epidemic there. Neither
is there any doubt that every case of the disease, not
readily accounted for by contagion, would be found traceable to contact with goods or groceries received from
cities or towns infected with the disease: In some plantations the disease was introduced and prevailed epidemically among the Negroes from contact with the rope
or bagging received from New-Orleans.
Of this same epidemic, of 1853, which, in Philadelphia, spread only to a limited extent, Dr. Holcombe,
of Natchez, furnishes the following facts with regard to
that locality: " The first cases appeared in families, some
member or members of which had come from NewOrleans within a few weeks. The houses were not under the hill, along the river, nor in the suburbs, nor in
filthy, ill-ventilated, damp, and otherwise noxious places,
where, if at all, the disease might be supposed to originate.
They were pleasantly situated in the central parts of
the city, and the tenants all in comfortable circum



OR NON-CONTAGIOUS?             15
stances. There were three centres of emanation, whence
the disease appeared to spread in every direction, not
reaching the suburbs until after the lapse of several
weeks. Many of the inhabitants, who fled to the country, carried the disease with them.  One gentleman
sickened on the road, and stopped at the house of a
friend twelve miles from town, where he died of yellow
fever. One of the family speedily exhibited the same
disease, and died; another fled into an adjoining county,
where he also sickened, and communicated the disease
to those around him." In several cases which came under Dr. Holcombe's observation, the families in the
country were carefully isolated, with the exception of
one messenger, who was permitted to visit the town on
necessary business, and uniformly the messenger was
the one first attacked.
From all these facts, which are no doubt well authenticated, we are led to conclude that the yellow fever shows
itself in its deadliest form only when concentrated, as on
board of a ship, particularly in woollen clothing, and
can thus be propagated ad libitum. But when diluted,
by being spread over a large part of the town to the
Pennsylvania Hospital and Blockley Almshouse, its
virulence is exhausted, and the disease is only propagated
in a milder form. The disease is modified by being
communicated from  one person to another; and some
are only sick for a few days, or have but a few of its
symptoms, so that no one would admit this to be the
terrible disease, yellow fever,.although produced by the
same potent cause. Whilst attending my slighter cases
of yellow fever, I was invariably affected by a few cha



16                  CONTAGIOUS
racteristic symptoms of the disease, which, however, soon
passed away. One case of this kind, subsequently observed, was very striking. During the violent epidemic
of 1856, Mr., went to Norfolk to nurse the sick.
After his return home he was attacked by the disease,
and died under allopathic treatment. His daughter,
Mrs. S., my patient, merely saw the corpse, and was, in
a few days afterwards, attacked by some symptoms very
characteristic of yellow fever. I told her husband that
if I did not know that there was no disease of the kind
in the city, I would suppose it was a slight attack
of yellow fever. At the time I was not aware of her
father having died of that disease, and her having
visited the corpse. But, still further, his wife, having
nursed him during his illness, afterwards went into the
country, and was there seized with violent pains in her
head, with bilious vomiting, &c. She soon recovered.
These persons were not severely affected by the yellow
fever, but their symptoms were evidently produced by
the same miasmatic virus.  Is this strange?  Is not
the whole theory of homceopathy based upon this fact?
Do not all our remedies act, in a diluted form, much
milder than when concentrated? Do we not, on the
other hand, know that this action is very much influenced or modified by what we call the peculiar susceptibility of the patient or individual to the particular
poison? We may, I think, lay down two axioms as
nearly correct: 1. That yellow fever will only show
its deadliest effect when in its most concentrated form;
2. That there must be a peculiar susceptibility of the
individual to this particular poison at the time of his




OR NON-CONTAGIOUS?            17
exposure, in order to show its most penetrating
effect.
This view of the question of contagion and non-contagion holds good with all epidemics. Cholera, e. g.,
furnishes its greatest number of victims with those first
attacked, whilst, during the progress of the disease, the
cases are constantly getting milder. In the case of
small-pox a similar law prevails.
CHAPTER III.
ANALYSIS OF THE PATHOGNOMONIC SYMPTOMS OF THE
YELLOW FEVER (1853) IN TEN CASES, AS FURNISHED
BY DR. GILBERT, THE PORT PHYSICIAN.
FEVER, without remission, until the end of the third
day, then prostration without reaction, in every case.
Sallow skin and eye, bronzed color of skin, sallowness of conjunctiva, are mentioned in four cases; yellow
skin in two cases.
In three cases there was black vomiting.
H-emorrhage from mucous surfaces, two cases.
Excruciating pain in the loins in three cases. In
addition to this, in one case, pain in the head and limbs..
In those that recovered there was no yellow or
bronzed skin; no black vomit; but in two there was:
headache and nausea.
2




18                  ANALYSIS
ANALYSIS OF THE SYMPTOMS OF THIRTY-FOUR ADDITIONAL
CASES, TWENTY-SEVEN OF WHICH WERE REPORTED BY
DR. JEWELL, AND NINE FROM THE PRIVATE PRACTICE
OF DR. STOKES, OF PHILADELPHIA.
Some symptoms may have been more frequent, but,
as they were not found in the record, I could, of course,
not mention them. I have been limited to the often imperfect delineation, partly because, the physicians attending neglected to make careful notes, and, partly, they
were only called in at the more advanced stage of the
disease, and thus received an imperfect relation of the
previous symptoms by the nurses and friends of the
family.
The symptoms were, no doubt, also modified by the
allopathic treatment; although I have never seen any
disease that is less modified by medical treatment than
this fever, unless the remedy is absolutely specific. In
twenty-six of the forty-four cases there occurred the
peculiar dark-colored "coffee-ground" ejection from the
stomach, known as the black vomit. This substance,
when placed within the field of the microscope, exhibited the true blood-corpuscles, denoting its sanguineous
character.
HEAD.
Severe pain is mentioned in eighteen cases; in one
case there was more headache than any other symptom
the second day, less pain in the head and limbs after
taking Calomel, Rhubarb, Nitre, and Ipecacuanha. In
one case, the disease commenced with excessive pain
over the right eye and temple at night.




OF SYMPTOMS.                  19
Great pain in back of head in two cases; and in one
case back of neck also.
EARS.
Considerable deafness in one case, and slight in two
cases. (Two drachms of Quinine were taken in two of
them, and also large doses of Ipecac., Quinine, and Calomel in one of them.)
EYES.
Eyes injected is mentioned in thirteen cases; slightly
in four cases. Conjunctiva red and slightly tinged with
brown, the second day, one case. Eyes red and fiery,
three cases. Eyes red and fiery, and yellow, one case.
Eyes purulent, one case (after taking Calomel, five
grains, every two hours for a day).
NOSE.
Hsemorrhage frequent from the nose during the third
and fourth day, in six cases.
FACE.
Face dark, suffused, or flushed, is mentioned in three
cases; the second day, with an expression of greatest
anxiety, in one case.
Purplish tint on face and upper extremities (after
taking five grains of Calomel every two hours).
Less suffusion of countenance the fourth day, one case.
Suffusion of countenance, giving the tipsy look so
common in this disease, second day, one case. (Is this
the reason why alcoholic drinks are so useful in this
disease as curatives?)




20                   ANALYSIS
TONGUE.
Tongue perfectly natural in two cases; or to the touch
in two cases. Tongue moist in two cases; with paste-like
centre two cases; with pale red edges two cases; tongue
bright'red, third day, one case; red at the tip and edges,
fifth day, one case; the same patient had the tongue
dry and the teeth covered with black sordes on the
sixth day. Tongue coated white in eight cases, with
bright-red edges in five cases, Tongue scarlet-red, first
day, one case. Tongue coated and dry, presenting a
brownish appearance, much worse on second day, one
case. Tongue furred and soft in three cases. Tongue
less moist, deeper red, second day, in two cases. Tongue
dry, parched, red like raw beef, on the second day; red
at the edges, dark in centre and base, on the third and
fourth day, in one case. Tongue white in centre, with
pale-red edges, became fiery red on the second day, in
one case.
EPIGASTRIUM.
Intense epigastric uneasiness, with great tenderness
on pressure, in twelve cases.
Great distress over epigastric region, oppression about
the heart, and nausea, with fever, continuing five days,
when the fever abated. From that time to the period
of death-fourteen days-the above symptoms continued
unabated until she died, one case.
Pain in the epigastrium, increased by pressure, the
second day, in three cases.
Tenderness all over the abdomen in a woman of seventy
years of age. Tenderness in the epigastrium on second




OF SYMPTOMS.                 21
day (after large doses of Ipecac. and Quinine), oppression
over sternum and anterior portion of thorax, as if a
very heavy weight were laid there, one case.
Intense thirst on the afternoon of the second day in
two cases.
Intense thirst on the first day of the disease in six
cases. Some nausea is mentioned in one case on the
first day, and in one on the fourth day.
Cqnstant nausea on the second day in three cases.
(One of these patients, after taking Calomel and Rhubarb, had the next day no nausea, nor tenderness of the
epigastrium.)
Nausea and vomiting on the first day, one case.
Nausea on the first day, but not on the second (after
Ipecac. and Quinine).
Vomiting of food, then froth, but no bile, in one case.
Stomach exceedingly irritable in two cases, ejecting
everything, even ice-water, one case.
Vomiting of a watery fluid in two cases.
Vomiting of glairy mucus in one case.
Continual vomiting in two cases; the vomiting in one
case, which recovered, occurred at intervals.
Black vomit, or like coffee-grounds, or lees of porter,
in twenty-six out of the forty-four cases.
Vomiting of grayish fluid, mixed with blood, on the
second day of the disease, in one case.
Bowels costive in four cases; on the first day is mentioned in two cases.
Bowels loose, moved four times a day, one case (after
taking a drachm of Magnesia.
Bowels moved twice, first and second days, one case.




2 2                  ANALYSIS
Bilious evacuations (after four grains of Calomel and
one-quarter grain of Opium).  Evacuations of dark
color and tar-like consistence (also after repeated doses
of Calomel), one case.
Several copious stools, of green color, on the second
day, one case.
Evacuations of orange-yellow color on the fourth day
in one who recovered.
URINE.
Complete suppression of urine on the first day, but
the same patient passed some water on the second day.
Suppression of urine on the fourth day (in one who
died afterwards).
Urine scanty first day in one who died.
Respiration hurried the second day is mentioned in
one case.
BACK.
Back of neck, intense pain.
Iurnbar region or back, severe pain in fourteen cases.
EXTREMITIES.
Pain or cramps in the limbs in ten cases; in three the
calf of the legs is mentioned; excessive pain in the legs
on being roused up at night in two cases.
Pain in fingers or toe-joints in one case.
Extremities cool, one case.
PULSE.
Pulse, as being full hard and frequent, is mentioned
in two cases on the second day; as being feeble in another




OF SYMPTOMS.                  23
case; then, again, in one who recovered, the pulse was
at first sinking, but became afterwards full and tense.
The frequency of the pulse varied in almost every
patient.
In one who recovered it was 78; then again pulse
varying from 80 to 100 in one case.
Pulse 80, two cases (after five grains of Quinine and a
large dose of Ipecac.)
Pulse varying from 86 to 90; at first full, afterwards
feeble and small.
Pulse 82, regular, and of ordinary fullness, first day.
Pulse 86, second day.
Pulse 98, first day, of moderate strength and fullness;
second day more feeble. Recovered.
Pulse 100 in two cases. First day full and tense; on
the second day 120, full and tense.
Pulse 100; harder and fuller on the third day.
Pulse 104, feeble and compressible. Same person,
second day:
Pulse 120, weak and compressible.
Pulse 110, one case.
Pulse 115, full, tense.
Pulse 120, strong and active first day in two cases;
114 second day.
Pulse 129 at first; the third day 106, and on the
fourth day 92.
Pulse 130 throughout in one case.
FEVER.
Chill,, followed by fever, in five cases.
Chills, followed by severe fever, in four cases.




24                    ANALYSIS
Chills, followed by fever, two cases the first day.
Chilly first and second day, one case.
Very little fever in one case.
Violent fever, in a woman of seventy, first day.
High fever for two days, one case.
High fever, with great thirst and drowsiness, one
case.
Some chilliness, cold extremities, one case.
Severe chills, one case.
Burning internally, one case.
Delirium  on the third day in two cases.
Delirium slight in three cases on second day.
Muttering delirium, one case.
Delirium increasing in second stage, one case.
Depression of spirits, one case.
SKIN.
Body covered with a petechial eruption, one case.
Red spots over the extremities, one case.
Skin, from the commencement of the attack, was of a
yellow hue in four cases.
Skin began to be yellow on the second day, one case.
General yellow hue of skin and conjunctiva in four
cases.
The blister which had been applied over the epigastrium, on being cut, stained his linen a yellow hue.
Yellowness made its appearance on the third day of
sickness (in one who died).
Skin hot and dry in four cases, but not yellow.
Skin burning and dry in one case.




OF SYMPTOMS.                 25
Heat of skin less marked on second day, and still less
on third, one case.
Heat of skin considerable on second day, one case.
Skin somewhat moist on second day, one case.
GENERAL SYMPTOMS.
Great debility in three cases.
Such prostration of strength at the beginning of the
disease that he was with difficulty enabled to reach his
residence, only two squares distant, and from which he
had walked with ease only one hour and a half before.
Lassitude, one case.
Great prostration first and second day, one case.
At the very commencement of the disease great prostration, one case.
General soreness, one case.
Stupor is mentioned in one case.
Less stupid the second day, in the afternoon; stupor
increased the third day, one case.
SLEEP.
Considerable drowsiness.
Restlessness and drowsiness, with coma, in two cases.
(One of these patients had fallen from a height a week
before.)
Restlessness at night with delirium, second night,
hard to rouse, one case.
Patient sleeps almost continuously.
Little sleep during the second night of the disease,
one case.




26                   ANALYSIS
SYMPTOMS OCCURRING DURING THE LAST STAGE OF THE
DISEASE, OR BEFORE DEATH.
Mind muddy, but answered correctly when questioned.
Mind clear one day before death, in two cases.
Difficult to rouse; intellect dull one day before death.
Headache one day before death mentioned in one
case.
The eye at this stage assumes a peculiar pinkish hue
in five cases.
Before death the eye became jaundiced, and the skin
bronzed in appearance, in two cases.
Five hours before death the eyes are of a delicate
pink color, slightly streaked with yellow, one case.
Eyes lustreless, conjunctiva injected, one day before
death.
Epistaxis of dark blood in the morning, and returning in the evening, with rapid prostration, one case.
fobnue remains clean, one case.
Tongue large and soft, white in middle, with red
edges and tip, one case.
Tongue thickly coated white on second day, the patient dying in forty-eight hours.
One day before death, tongue intensely red, dry, and
protruded with difficulty, one case.
Tongue red at tip and edges, with brown dry centre;
sordes on the teeth one day before death, one case.




OF SYMPTOMS.                  2 7
Expectoration of a little blood before death.
Black vomit in twenty-six cases out of the forty-four.
Rejected everything taken into the stomach, resisting
all stimulants, gulping up everything by the mouthful,
in two cases.
Very tender over the epigastrium and the right iliac
fossa, one case.
Extreme tenderness of the epigastrium one day before
death in three cases.
When in articulo-mortis, the evacuations from  his
bowels were liquid, and of a darker color than the matter vomited, in three cases.
Dark fluid discharges, tinged with blood, on the third
day, one case.
Several black and bloody stools during the night,
one case.
Involuntary black and watery discharges, one case.
Intense thirst fifth day, one case.
Suppression of urine one day before death.
Pulse 108, soft and regular.
Pulse more feeble, two cases.
Pulseless; sinking rapidly on the second day, one case.
Pulseless on the fifth day, without sense or motion:
died without convulsion, one case.
Pulse about 80, feeble, and very compressible, one
day before death, one case.
GENERAL SYMPTOMS.
Convulsions before death in two cases.
Continual sighing and tossing in bed, one case.
Muscular tremors, one case.




28                 1 ANALYSIS
Extremities cold one day before death.
Great prostration on the fifth day in two cases; in
one case on the third, and another on the fourth day.
Patient lies motionless on the seventh day, one day
before death, one case.
Sinking on the sixth, one case.
Three died on the sixth day, 3, P.M.; one on the
eighth, and two on the fifth day. One died three hours
after admission into the St. Joseph's Hospital; one died
in fourteen days, and one in three days and a half; two
in forty-eight hours.
Four deaths occurred on the fourth day, and three
on the second day; one on the third, and one on the
thirteenth day.  One case was cured in seven days,
which, according to Dr. Gilbert, the port physician,
seems not to have been genuine yellow fever.
One patient, who died on the eighth day of his disease, said, not long before his death, that he felt "very
well, as if he were going to the other world."  In this
case the symptoms have not been detailed after the
second day, as large doses of Quinine and Calomel
modified them to such a degree that they would be
of very little account.
SKIN.
Skin cold and system collapsed, one case.
Skin cold and clammy; numerous small spots, injected, of a deep red color, made their appearance upon
the neck, breast, and arms, as it were in clusters.
The eye and skin before death were slightly tinged
of a yellow hue.




OF SYMPTOMS.                29
Skin cool and of a pale lemon color one day before
death, one case.
One day before death increase of sallowness, extending to abdomen, one case.
Before death skin bronzed appearance, one case.
One day before death skin became very yellow in
three cases, accompanied with the greatest sensibility
to the slightest touch, in one case.
Five hours before death the yellow skin was most
conspicuous on the breast and neck, one case.
On the second day the skin of the person who died
in forty-eight hours became yellow universally, increasing in intensity toward the evening of the same day.
Thirty hours after death the body became quite black.
Skin very yellow after death, one case.
Six hours after death skin is very yellow; vibices on
extremities very dark in color, in a woman of seventy.
Five hours after death skin deep yellow, mottled with
purple down the back; lower extremities less yellow,
one case.
Dark-yellowish tint, very marked in about twelve
hours after death, although but little yellowness had
been observed during life, one case.
Of the forty-four cases thirty-four died.
The mean duration of the disease in those who died
was four days.
The black vomit, when placed within the field of the
microscope, exhibited the true blood-corpuscles.
In eleven of the thirty-four deaths a post-mortem was
made, in all of which the yellow or ochre-colored liver
was detected, in whole or in part.




30                  ALLOPATHIC
In all of them the " coffee-ground" fluid, or melanic
blood, was found, either in the stomach or intestines,
with other evidences of a pernicious form of fever.
CHAPTER IV.
ALLOPATHIC TREATMENT.
ON reviewing the treatment of the different writers we
are not surprised that thirty-four died out of forty-four
cases-a mortality equal to eighty per cent.
No indications are furnished by these writers of any
individual application of a particular remedy. After
the enumeration of a few of the most prominent symptoms, the author says: "Ordered Calomel, ten grains
every two hours, and then Quinine, ten grains." The next
day these remedies are changed, without giving any
reason. It is just like the mariner steering without
compass or rudder in the wide ocean.
Calomel, Epsom-salts, with Quinine, aggravated one
case which was subsequently benefitted by Chlorate of
Potash in solution.
Removal from the infected district was one of the
best means of preventing a fatal issue.
In one case, that of a nursing mother, the return of
the milk was the most favorable sign.
Dr. Jewell, the reporter of the cases to the Medical
Society of Philadelphia, speaks of the treatment pursued as follows: " In the first stage of the fever the treat



TREATMENT.                  31
ment in general has been by blood-letting from the
arm, and by cups to the back and abdomen, emetics
mercurial purges, diaphoretics, &c. During the second
stage, or as soon as a remission took place-which was
generally about the third and fourth day from the attack-Calomel, as a sialogogue, was administered in
some cases, in others Quinine, in three or four-grain
doses, every one or two hours. In the event of no
speedy reaction, Brandy or Wine internally, and local
stimulating applications, by blisters and rubefacients,
were resorted to.
" Quinine, in full doses, on the first intimation of a remission from  fever, appears to have been a favorite
remedy. In some cases over seventy grains were administered daily for several days, and, as far as we could
learn, without any annoyance to the brain, or other
organ, but with advantage. (?!) It will be remembered,
however, that the cases at the Blockley Almshouse Hospital were treated without Quinine in any stage of the
disease. Calomel, pushed to salivation, was the principal
remedy employed."
Such is the model treatment of the best allopathic
physicians of Philadelphia in the nineteenth century;
and all this with the full knowledge of the superiority of the simple treatment of the Creole nurses in
New-Orleans over the usual Calomel treatment, to say
nothing of the acknowledged success, in this disease,
of the homceopathic physicians at New-Orleans, Charleston, Natchez, and Norfolk.




32                 HOM(EOPATHIC
CHAPTER V.
HOMCEOPATHIC TREATMENT.
ALTHOUGH yellow fever did not prevail very extensively or epidemically in Philadelphia during the year
1853, nevertheless the victims which it claimed were
not a few, and its ancient character of virulence was
fully manifested.
The first case which fell under my notice presented
some peculiar features. It was that species which, from
the beginning, assumes a typhoid form.
M. W., aged seventeen, having come in contact with
a person from the so-called infected district, complained
the next day of drowsiness, pain in the bones, sleeplessness, &c., presenting, on the second and third day, the
following group of symptoms:
In the middle of the day, from eleven, A. M., to four,
P. M., there ensues a febrile paroxysm, with burning
heat and redness on the left cheek-the whole face assuming a mahogany color; the mouth is half open, and
the patient lays in bed with his eyes shut. On being
questioned, he always answers that he has confused sensation in the forehead, as if a tight band was tied over
his eyes to the back of the head, with giddiness.
Towards evening the fever remits, but he is never entirely free from it.
The skin has a peculiar uniformly hot sensation to the
touch. The pulse was from 80 to 90. Bleeding of the
nose for several days, sometimes as much as half a pint.




TREATMENT.                 33
To this he had been formerly subject-the blood coagulating with difficulty. The tongue was dry and parched,
black in the centre, the edges slightly moist; tip of
tongue very red and dry. Great thirst. One morning
also vomiting of bile.
The fifth day pain and swelling of the stomach, with
soreness to the touch; in the night slightly delirious.
Constipation of the bowels at the commencement, but,
during the progress of the disease, he often had diarrhcea. The urine was yellow, cloudy, and he only passed
a small quantity. Deafness.
As I had then never seen a case of yellow feverknowing its character and symptoms only from books
and lectures, I called in Dr. Howard, of this city, who
had the reputation of being familiar with the disease
during his residence in Cuba. He immediately pronounced it to be a genuine case of the disease, and of
the typhoid form.
TREATMENT.
Aconit.-nap., 1, and Rhus-tox., 1, repeated every one
to two hours, relieved the thirst, the bleeding of the
nose, and pain in the stomach; but the other symptoms
remained the same.
The patient received consecutively, from September 20
to 21, Aconite and Nux-vomica; September 22, Opium,
1, Bellad., 6; and in the evening of the twenty-third of
September, Crotalus Horridus, 7, in water, in alternation with Bellad., 6; finally, up to the first of October,
the following remedies: Arsenic, 3, Hippom.-mancinel3




34                   IOMCEOPATHIIC
la, 7, Lachesis, 6, Merc.-sol., 1, Sulphur, 1, Phosph. and
Phosph.-ac., 2, Veratrum, Kreosote, and Quinine.
These remedies were repeated every hour or two
hours; for the obstinacy and inveteracy of the disease
was so great that, if the remedies were not thus often
repeated, the disease would assume an alarming form.
The sopor, dry tongue, fever, &c., were most conspicuously relieved by Kreosote and Phosph.-acid; but
the improvement only lasted a day, and the symptoms
always returned with the same violence, and I did not
consider myself justified in continuing longer their exhibition.
A slight perspiration only was produced during the first
day by Aconite, and a profuse one at the crisis, towards
the twenty-first day, by UCootclus Hornridu.s, 3.* That this
crisis was very much aided, if not entirely produced by
Crotalus Horridus, in the lower triturations, we may
well assume, firom  the circumstance that, in the seventh
dilution, it had very little or no effect; and that, even
after the twenty-first day, when the Crotalus was omlitted for too long an inteIrval, the old symptoms of dry,
parched tongue, the sopol, &c., would return with the
same virulence; but, when the remedy was continued
with perseveruance, lie agt in perspired in the night, and
all the other symptoms imlproved.
On exanmining the symptoms of Crotalus, for the pur* The Crotalus, in order to produce its most powerful effect, must
be taken from the snake in summer-if possible, immediately after
catching it-and triturated with sugar of milk, and preserved in wellcorked bottles  The preparation with alcohol, as is now well known,
has very little or no effect.




TREATMENT.                      35
pose of prescribing it in this disease, I found the simi
larity to the symptoms before me so great that a cer
tain involuntary conviction took possession of my mind
that this must be the remedy so long sought for. The
reason for its not acting promptly in the seventh dilution
was that, in such a severe disorder, larger doses ought
to be employed.* Moreover, if the virus of the Crotalus was not of some such high import, the use of this
class of animals could not very distinctly be seen. Besides it had already been extolled by several persons as
a superior remedy in this disease. Inl a letter from
New-Orleans, addressed to Dr. Bute, it was mentioned
as having cured two cases. A captain of a Brazilian
vessel always procured a stock of Crotalus before sailing, alleging that it was the only reliable and sure
specific in yellow fever.
In 1857, Dr. Jose Luis Lorenzo Bablot Valdez, of
Cuba, furnished, in his inaugural dissertation, a very
minute comparison between the  symptoms of yellow
fever and those obtained by the pathogenetic action of
Lachesis as well as Crotalus Horrid., and the similarity,
yes, absolute identity, is, indeed, very remarkable. Valdez instituted these comparisons in consequence of the experiments of a Dr. Humboldt, who, as we shall soon fully
detail below, inoculated, at Havana, the venom of some
serpent (supposed to be Crotalus) with a view of pre* That a dilution even one degree lower will often cure where
the one next to it has failed, has been corroborated to me lately in a
case of whooping cough, where the second dilution of Mephitis-putor
was only of slight benefit, but where the first dilution cured at once




36        ~T~HOMIEOPATHIC
venting or modifying the yellow fever, in the same way
as the vaccine virus is used for the prevention of smallpox.
What particularly struck me in this disease, and in
which it differs from every other that ever fell under
my observation, is its character of extreme obstinacy
and treacherousness. Only malignant scarlatina is to
be compared with it in this respect. There was no possible time to wait for the -reaction of the medicine when
the patient was better; but he required unremitting attention, and a continuance of the remedy every hour
until the disease was totally subdued.
Every inch of ground had to be contested in this
disease; for, when apparently entirely well, and the
tongue had become moist, I omitted one night the continuance of the Crotalus; the next morning the tongue
was dry and parched in the centre, and I was compelled to administer it every two hours, for several
days, until he was cured.
Even after a decided improvement in his whole condition, and during the action of the Crotalus, which was
continued all the time, he had, every other afternoon, a
creeping sensation down the back and all over, followed
by heat and perspiration.
During the first four days after his improvement
commenced the patient was confined to oyster soup and
different kinds of fruit, such as grapes, pears, &c., and
these only in small quantities at a time, but often repeated. After the twenty-first day the appetite returned, and I had great difficulty in restraining it.
In every case the patients were ordered to have their




TREATMENT.                  37
bed-linen changed every day, as well as their own clothing; and, as far as practicable, daily ablutions were performed, and, I may say, not without very great and
visible advantage.
Several other cases, having all the unmistakable characteristics of the disease, were also chiefly or exclusively
cured by Crotalus, although they were of a milder nature.
2. Mrs. H.-First day. Felt an unpleasant chilly feeling.
Second day: Dragging pain in breast and lower part of
stomach (liver). The most characteristic symptom of
the disease was always this pain. Third day. Creepy
chills all day; nausea and vomiting of bile; chilly feeling, alternating with heat, without the slightest perspiration; pain in the small of the back (region of kidneys); pain in the flesh all over. Fourth day: Drawing
pains in the knees, as if the joints were too short; giddiness in the head; drowsiness, sleepiness, all the time;
confusion of the head, saltish bitter taste in the mouth.
The second day the bowels were freely opened; since
then costive, no appetite.  Since the first day no thirst;
water has not the right taste; pulse 90. Fourth day,
P. x.: Sore pain beneath the left shoulder-blade to the
abdomen, where a swelling can be felt, and across the
region of the kidneys or loins. The region of the liver
is very sensitive to the touch; foul, fetid breath; bitter
taste in the mouth.
Crotalus Horridus, 3, in water, repeated from  one
to two hours, diminished the violence of the symptoms
from day to day, and entirely cured her in the space of
a week.




38                 I03OMCEOPATRIC
3. Mrs. R., in the same house as the above patient,
was attacked on the twenty-first of October, at eleven
o'clock, A. M., with the following symptoms: Darting,
burning pains on the top and back of the head and over
the eyes, shifting about; bewilderment of the brain;
slight pain in the stomach and liver, and soreness in
the right kidney; nausea and sickness of the stomach;
constipation; fever, with the peculiar dry heat on the
surface. Crotal. Horrid., 3, after aggravating all the
above symptoms for a day, cured her on the third day.
Afterwards she had severe shooting pains in the right
hip, extending to the sacrum of the same side, with
heat. These symptoms were evidently the result of
the preceding fever, and were so obstinate and violent
that a week elapsed before she was entirely cured of
them.
4. D. P., aged fifteen.-The disease commenced on
Friday afternoon with dull pain in the forehead, with
weakness and pain all over. On Friday night the fever
set in, for which his mother prescribed Bellad.  On
Saturday he was better all day; but in the night the
fever returned, and he felt very nervous. On Sunday
morning a swelling of the parotid glands ensued, and
in the evening of the same day, at seven, P. M., bleeding
from the right nostril, relieving the headache; after
which dull pains over the right eye-brow set in; the
nose and cheeks became red, face dark colored, hands
almost black; constant inclination to pass water.
-Fourth day: Continual drowsiness and sopor; sweetish taste in mouth; foul breath (the characteristic smell
is more of a mouldy kind); great thirst; tongue dry in




TREATMENT.                  39
centre, point red and dry; attacks of light-headedness;
sensation as if falling over a precipice; blisters on top
of nose, with redness. This case was also cured by
Crotalus, 2, in a few days..5. Mrs. M.-The disease commenced, as usual, with a
crawling sensation up and down the back, with chilliness all over in the afternoon, which lasted from five to
six hours. Afterwards heat from head to foot; at the
same time the head felt light and confused.
Severe tension and pressure on the top of the head,
extending to the ears; soreness in the pit of the
stomach to the left shoulder; pain in the bones.
Bowels at first relaxed, afterwards costive.
Yellow face, and tongue coated yellow; bitter taste
in mouth; nausea; dull pain across the hips; aching
pain in the centre of the chest to the back, shooting
down to the arms and back of the head, and the whole
spine; constant inclination to void urine, which is dark
brown, almost black.
Crotalus Hor., 3, very quickly relieved all the above
symptoms in a few days; but not a tickling dry cough
in the centre of the chest, for which Stannum, 3, was
prescribed with benefit.
Although the above, and several similar cases of the
epidemic of 1853, attended by me, but not described here,
had none of the severity which generally characterize
the disease, they still showed some well-pronounced features common to them all; and, even in their apparent
mildness, there was an obstinacy and inveteracy which
are never met with in any other disease, and in which
I could distinctly trace, even in this modified form,




40                 HOMIIEOPATHIC
their relationship to the more malignant type of the
disease, and to the same miasmatic cause. After the
more violent symptoms of the disease had subsided
there was a disposition to locate itself in some particular organ, as the right hypochondriac region or the
liver, &c. I remarked that the right side was almost
invariably this depository.
In 1858 there occurred not a few cases of genuine
yellow fever in the city of Philadelphia, which, although
they were of a milder and more modified type, could
still be traced to this common source of infection.
I will here detail a few which may be comprised under this head, and which fell under my observation:
6. Mrs. B. came from Delaware with a disease which
was supposed to be dumb ague, but which I would
rather class among those anomalous cases of yellow
fever, because some of the main symptoms were more
similar to the yellow fever epidemic of 1853 than
to the intermittent fevers of this neighborhood. The
symptoms were: Chilliness, without thirst; pain all over
the brain, as she expressed it, and not in any particular
part; aching in region of liver and spleen, proceeding
from right to left; diarrhcea, with much flatulency;
much swelling across the stomach, with soreness to
touch; headache during the chill and fever.
7. The above case, and that of her little son, H., similarly affected, were both cured by Crotalus Horridus,
aided by Quinine, and, at a later period, Arsenicum.
Both had the characteristic dirty yellow skin.
8. Pauline R., aged eight, had been sick for three
days, with mouldy smell from  mouth, tongue coated




TREATMENT.                  41
white, very thirsty, pulse 100; sore, aching pain in
region of liver; constipation of bowels; aching in forehead; also, sore throat, yellowish, dirty complexion.
This case was arrested in a few days by Crotalus Hor.,
second trituration, aided by Hippomanus-mancinella,
exhibited alternately every hour.
9. The last case of the year 1858, and which proved
fatal, was under allopathic treatment for three weeks
without relief. The patient was not a regular drunkard,
but a regular drinker; that is, he partook of six or
seven glasses of brandy per day, which, as his friends
truly averred, may be partly the cause ot the fatal issue
of the case. Bating his unfortunate drinking habits, he
was a respectable man, much beloved by his friends and
family. He contracted the disease on the wharf, where
he had his place of business.
On my first visit I marked down the following symptoms: The disease commenced with aching in the back
of the head and spasmodic pain in the stomach, for
which large doses of Laudanum had been administered;
after which he was attacked with severe pain in the
back and violent headache.
Constant fever, with only slight or no perspiration,
remitting somewhat in the morning, but returning with
greater violence in the evening.
Wandering delirium.
Much thirst.
Constant drowsiness.
Mouth sore, as if he had been salivated.
The particular mouldy smell from the mouth.
No appetite. Tongue dry.




42           HOMCEOPATHIC TREATMENT.
Four or five black, pappy evacuations a day before I
was called in. The passages are now more natural.
The usual allopathic treatment was, Opium, Ipecac.,
Mercury, and then, again, Mercury and Opium.
After the exhibition of Crotalus, second trituration, in
alternation with Arsenicum, all his symptoms improved:
his tongue became moist, and, for some days, we thought
he was well. On account of his typhoid symptoms, viz.,
perfect indifference-low delirium-I now interposed
Rhus-tox., 2, in water; but all the symptoms were aggravated, and I again resorted to Crotalus and Arsenic,
both of which seemed most analogous to his present
state. He immediately improved; and the next day a
warm perspiration broke out, the delirium ceased, and
every one thought he would recover. But he now began to sink, and the tongue became dry again. Brandy
and wine, in small quantities, with nourishment, barleywater, grapes, &c., did not prevent a fatal issue of the
case. The reaction from the medicine and exhaustion
firom the disease were simultaneous.  He could not
rally. Death was the master, and closed the scene.
During the fatal epidemic at Norfolk, Virginia, I requested the late Dr. Campos, of that place, by letter, to
employ the Crotalus Horridus, sending him a portion of
it in triturations. He tried it in several instances, but
without any beneficial results, as he avers.
A similar experience has been reported to me by Dr.
Lingen, of Mobile, Alabama. He used different homceopathic remedies, according to the prominent indications,
and with success. Of the Crotalus he saw no beneficial results.  Other physicians in the South have been




SYMPTOMS OF CROTALUS HORRIDUS.        43
using the Crotalus with more or less success in this
disease.
It is possible that the more severe cases can no
more be benefitted by this remedy than by any other.
Besides, if an improvement did not ensue very soon, in
a dangerous and suddenly fatal disease like yellow fever,
the physicians would feel themselves justified in changing
the remedy at once for another. The forms of disease
attended by me were all of a lighter kind, and, therefore, more easily influenced by the remedy. I may remark, at the same time, that, in all cases, a decided
benefit from the remedy was not perceptible until the
second day. It had to be continued every hour for a
day before reaction took place. The remedy ought to
be exhibited on the first onset of the disease in order to
be most useful and active. If the system is overpowered
by the disorder no remedies will be able to rescue it.
CHAPTER VII.
COMPARISON OF THE SYMPTOMS OF YELLOW FEVER WITH
TIHE PATHOGENETIC SYMPTOMS OF CROTALUS HORRIDUS.
WE will now compare the symptoms of the yellow fever epidemic of 1853 with the _pathogenetic synvptomns of
Crotalus, contained in "Jahr" (originally from C. Hering) and "Mure." Although some other descriptions
of yellow fever symptoms might have been more com



44                 SYMPTOMS OF
plete, I have preferred to compare the Crotalus symptoms with Dr. Jewett's description of the symptoms of
yellow fever, because it was during the same year I exhibited the Crotalus in ten slighter cases, several of
which have been detailed atove. Can there be a better
fac-simile of yellow fever than the following verbatim
extracts from the authentic pathogenesis of Crotalus?
GENERAL SYMPTOMS.
Languor and sudden decrease of vital force, with
fever.-JAHR.
Yearly recurrence of blue-yellow spots, with swelling,
pains, and fever.-JAHR.
Dr. Fellger, of Philadelphia, mentioned to me, as a
well-authenticated fact, that Heinrich Witte, of Northampton County, Pennsylvania, fired a shot among hundreds of rattlesnakes copulating in the forest. After
quitting the place without being bitten, from the mere
deadly effluvium of so many snakes he had pains in the
whole body, which became swollen, and also vertigo,
lasting nearly nine months. Since then, now ten years,
every year, about the same time, he has a return of the
same symptoms. His skin assumed a dirty-yellow color,
and has remained so ever since.
[The sister of O. P., the patient whose case we detailed before, was also attacked with the same disease,
and similar symptoms to his own. She was cured in a
short time by Crotalus and other remedies; but, a year
afterwards, about the same time, she was again attacked
by the very same disease, only with greater violence, and
without the possibility of a fresh exposure. I am now




CROTALUS HORRIDmUS.              45
convinced that it was the same disease slumbering in the
system. Her parents thought so at the time. In her
former attack she was chiefly treated and cured by
Crotalus. In the returning disease the same remedy
was again resorted to, and with benefit, but it soon lost
its effect. Other remedies were exhibited without relief (Opium, &c.) Typhoid symptoms set in, and she
died. She was always of a very weakly and delicate
constitution.
One of the most remarkable instances occurring in
my practice of the inveterate grasp with which the disease takes hold of individuals is the following: M. T. H.
resided, four years ago, at Porto Rico, where he became
attacked with yellow fever, treated allopathically, by
bleeding, Quinine, &c. This was in the month of March.
Now, every year, for four years, in the same month,
whenever he smokes a segar in the evening, the same
dry tongue, with the same headache as he experienced
at Porto Rico, is excited and returns. Cold water and
eating dissipate it.]
The symptoms return with greater violence after having remained quiet for two days. [This symptom is mentioned in " Jahr " as characteristic of Crotalus. In the
last case of yellow fever which I attended there was
nothing more characteristic than the suspension of the
disease for a day or two, and its more violent return,
without any particular cause than that of changing the
medicine.]
Most of the symptoms appear on the right side.JAHR. [Highly characteristic of all the cases which came
under my observation.]
Trembling of the whole body.-JAHR.




46                SYMPTOMS OF
MORAL AND MENTAL SPHERE.
Depression of spirits. —MuRE. Delirium, with muttering.-JAIIR.
HEAD.
Lancinations in the right temple; headache, as if the
forehead would split, with weight above the eyes; pain
under the right orbit and the right side of the forehead;
sensitiveness of the hairy scalp on touching.-MuRE.
EARS.
Deafness.-MURE.
EYES.
Redness of the eyes with lachrymation; yellow, faint,
sunken eyes.-JAHR. Yellow rings around the eyes;
dim, purulent look of the eye.
NOSE.
Discharge of bloody liquid from the nose.-MuRE.
Bleeding of the nose. —MRE.
FACE.
Flushes of heat in the face. -MRE. Yellow complexion.-MURiE. Yellow face for a long while.-JAHR.
TONGUE.
Tongue of a scarlet red. —M RE.  Brown, swollen
tongue.-JAHR.
EPIGASTRIUM.
Pain in the stomach and pit of the stomach, with
nausea and qualmishness; pressure in pit of stomach. —
JAHR. Burning pinching at the pylorus. —MuRE.




CROTALUS HORRIDUS.            47
THIRST AND HUNGER.
Unquenchable, burning thirst.-JAfIm.  Thirst.MURE. Fainting from hunger. —MRE.
TASTE, NAUSEA, AND VOMITING.
Sour taste. Rancid eructations. Hiccough.-JAHR.
[This symptom, according to Dr. Holcombe, occurred
in some bad cases.] Nausea shortly after the bite.JAHR. Inclination to vomit, with cold skin. Vomiting;
green, bilious, bitter, violent vomiting, every time he
eats. Can only retain jelly, coffee, and a little brandy.
[All these are from "Jahr."]
ABDOMEN.
Borborygmi. —MuRE. The abdomen is sensitive.MURE. Burning in the region of the liver.-JAHR.
Constipation.-MuRE. Yellowish diarrhcea.-MURE.
GENITO-URINARY ORGANS.
Emission of a deeply-colored urine.-MuRE. Urine
highly colored, red-yellow, as in jaundice.-JAuR.
Painful retention of urine.-JAHR. Haemorrhage from
the urethra.-JAHR. Metrorrhagia (vermilion colored).
I-MURE. Lancinations in uterus. —MuRE.
BACK.
Bruised pain in the back of the neck, from the larynx
to the chin and lower teeth; in sudden paroxysms.JAHR. Drawing from the neck to the epigastrium.MURE. Acute pain at the sacro-iliac articulation.MURE. Painful heaviness in the loins.-MURE. Inter
nal and contusive pain between the shoulders.-MuRE.




48                 SYMPTOMS OF
EXTREMITIES.
Both in the symptoms of the lower as well as the
upper extremities, produced by Crotalus, are to be found
the crampy and other pains so characteristic of yellow
fever; also cold feet. —MuRE.
SLEEP.
Irresistible drowsiness, even at noon.-JAHR. Sopor.
-JAHR. Somnolence the whole morning. Disposition
to slumber.-MuRE.  Sleeplessness.-MuRE.  Dreams
about dead persons and phantoms.  Dreams about
spiders attempting to crawl over her. —MRE.
FEVER AND PULSE.
Chilliness all over. Sense of chilliness. —MURE. Dry
consumptive fever, with dry tongue and thirst. Constant
fever, with thirst, bilious vomiting, palpitation of the
heart, anguish, quick and feeble pulse, languor, and
rapid sinking of the vital forces.-JAHR. Thirst during
the fever. No sweat during the feverish warmth. —JAHR.
Pulse from 100 to 130.-JAHR. Pulse feeble and quick,
with fever and languor. Pulse first hard, then quick,
then feeble and slow. Tremulous imperceptible pulse,
with loss of motion and speech.-JAHR. Pulse 98 to
104.-MURE.
SKIN.
Red pimples all over. Pimples resembling flea-bites,
afterwards becoming raised and exfoliating, leaving a
black point in the centre.-MuRE. Blisters and livid
spots on the body, with frequent fainting fits and imperceptible pulse.-JAHR.




CROTALUS HORRIDUS.             49
Bright yellow spots on upper part of right hand.MURE.
_Blwack spots over the whole body. —JAHR. Yellow
spots over the whole body.-JAHR.
The whole body and urine look yellow, as in jaundice.
-JAHR. The skin is covered with little blotches.-JAHR.
CASES OF BILIOUS REMITTENT FEVER.
Besides the slighter cases of yellow fever, severe cases
of bilious remittent fever, prevailing in Philadelphia
and its vicinity during the same years, were either
cured by Crotalus Horridus alone, or, at least, very much
aided by it, as the following cases will testify:
1. Mrs. R. walked out, late in October, in a district where
fevers from the Schuykill River often prevail, and contracted the disease. She was a robust lady, of floridcomplexion, and hardly ever sick. She had the peculiarity
of not perspiring, even in the hottest weather.
When called to see her, on the twenty-first of O)ctober,
the following symptoms presented themselves: On
taking a long breath, cough and pain on the right
side of the chest, with tickling and expectoration of
tough white mucus. We mention these symptoms first
because they were the most troublesome, and she complained of them more than any others; but the main
disease was the bilious remittent fever, with the following symptoms: Pulse from 130 to 140, the fever remitting towards evening and midnight, but never entirely abating; delirious; circumscribed redness on both
4




50                   CASES OF
cheeks; constant thirst; chilliness on drinking; fcetid
breath; peculiar mouldy smell from the mouth, which
characteristic symptom we have observed in the remittent fevers of this climate; fcetid diarrhcea and involuntary evacuations; great apathy. The above comprised the chief symptoms.
The cough was relieved by Laurocerasus and Lactucavirosa, after first prescribing Phosphor. and Sulph. without success.
The remittent fever was not at all affected by them.
Chamomilla, subsequently prescribed, merely caused a
mitigation of the symptoms. It was only after the use
of the Crotaluz  Horrid., 2, that the fever abated. The
action was so prompt and energetic that it made a strong
impression at the time upon my mind.
The tincture of Leontodon-tacraxacum is the only remedy which I saw act equally prompt in other cases of
bilious fever. The cases in which Taraxacum was preferred were characterized by the following symptoms:
Tongue peeling off in patches, leaving a dark red spot
underneath; tongue was never dry; bitter taste in the
mouth, with nausea, and often bilious vomiting; always
great fullness and heaviness in the forehead; oppression
of the chest, with affection of the kidneys. There were
of course, other symptoms, according to the peculiarity
of the constitution, but the above were common to
them all.
2. During a temporary sojourn in the country Mr. H.
was attacked by a malignant intermittent fever, gradually verging into the remittent type. The attending
homceopathic physician prescribed, from August 17th to




REMITTENT FEVER.                51
August 28th, 1857, the following remedies, with only
partial success: 1. Bryonia, 6, Arsenic, 6; 2. Phosph.,
1, Acon., 3; 3. China; 4. Cocculus, 6, Merc.-sol., 3;
5. Ipecac., 6, Bellad., 6; 6. Nux-v., 6; 7. Bellad., 6; 8.
Bellad., 30; 9. Taraxacum, 2; 10. Nux-v., 6, Acon., 3;
11. Stram., 9, Ars., 3; 12. Hyoscyam., 6; 13. Bellad., 6,
Arsenic, 3; 14. Quinine-sulph., 1/10; 15. Bellad., 6, Ipec.,
Tart.-em.; 16. Ipecac., Nux-v.; 17. Taraxacum, Arsen.,
1i, Tart.-em., 1/10; 18. Tinct. Taraxacum.
After my return, on examining the patient, I noted
down the following symptoms: The fever set in at
first with a violent chill, followed by severe fever and
perspiration all night; mouldy foul smell from the
mouth; centre of tongue dry, sides moist and whitish.
Accompanying the fever there was vomiting of the
food, without taste; urine thick yellowish-brown. After the first chill there was only fever at four, P. M.,
followed by perspiration at night, and the other symptoms as mentioned; also rigidity of the left side of the
neck.
This severe remittent fever was rapidly cured by
Crotalus Horridus, 1 and 2, taken for several days. The
Crotalus removed all the above symptoms: a few doses
of Quinine finished the cure.
3. Another cure by Crotalus, 3, is the following:
Miss    - had fever every afternoon, followed by coldness and shivering in the back, without subsequent perspiration, except in the hands. She also had nausea,
violent headache, and pain in the back, and thirst during the fever; restless morning sleep, with eyes half
open, also mouth open; pain in the bowels. In this,




52                   CASES OF
case Eupatorium-perf. had been exhibited, at first with
partial success.
The following additional cases, resembling yellow
fever, or the more malignant bilious typhoid type, may
also be mentioned here:
4. This case was more important, on account of the
peculiar character of the symptoms, and their great
severity, than any striking action of remedies. It was
evidently a case of malignant bilious fever; and, after
the patient's death, the whole body, and particularly
the face, assumed a complete yellow color.
When I was called in to attend the case, with two
other homneopathic physicians, the predominating symptoms were the loquacious delirium, with a desire to escape out of bed. The tongue wasyellowish brown, and
dry in the centre; the lips sore and cracked; and there
were sordes on the teeth. Stramonium, whose pathogenesis seemed similar to the above symptoms, was exhibited with the greatest benefit. ~The delirium and
wildness were all gone the next day, but the symptoms returned with renewed violence. New specifics,
selected according to their affinities, seemed at first to
exert a very beneficial effect, but afterwards failed.
Crotalus was one of these remedies, but gave only
slight relief. As the disease advanced, the pulse sank.
As usual, stimulants, like wine, were resorted to; but
what could they avail? They could only rouse the
flickering life for a moment.
A grand and strong nature had prematurely exhausted itself, owing to its ignorance of physiological
laws. Excesses in Bacho and Venere, and in the most




REMITTENT FEVER.                53
extreme style, had done the deed. The system was, as
it were, prepared for years to absorb such a disease, under which it had to succumb, as of a necessity, because
there were no stamina left.
5. Miss ~, fourteen years of age, had even a more
severe attack of the same disease than the foregoing;
but, her constitution being still sound, a cure was not
impossible. It was attained with great difficulty.
A  year before Miss's brother had the yellow
fever, at least his disease resembled very much the epidemic which then prevailed under the name of yellow
fever. A year later, just before her own attack, Mary,
her sister, was affected by a very similar disease. The
question may fairly be asked, Can the yellow fever contagion remain, in a dormant or inactive state, a whole
year in a house, and then, when favored by the state of
the atmosphere, be resuscitated, and infect susceptible
constitutions exposed to it? This question deserves our
most serious consideration. I do not say that both these
cases, recurring a year after the first one, were positively
yellow fever, but they certainly resembled the disease
very much.
The first symptoms marked down on the appearance
of the disease were as follows:
1. For several days continual fever; tongue streaked
yellowish brown in the centre, dry and rough.
2. Pain over the eyes.
3. Constant bilious discharges.
4. Appetite voracious.
5. Perspiration, without abating the fever.
6. Occasionally chills.




54                  CASES OF
7. Throat swelling internally.
8. Skin yellow.
After Crotalus Horridus, 3, all the symptoms improved, except No. 1. At the same time the skin became
dry, and remained so until the termination of the disease.
September 27th, 1855, five days later, the case presented the following symptoms: Tongue dry, brown,
and cracked in the centre, swollen, moist, and white on
the margin; deep red across the point, and dry; dryness of the throat; no desire for water, although the
mouth was dry and she had to moisten it; nose bleeds
a little all the time; tenderness in the left hypochondrium (after Phosph.-ac. the pain went to the right hypochondrium); after eating oranges the feetid smell disappeared and gave place to an acid one; yellowish,
watery, bilious passages four to six times a day; no appetite whatever; suppression of urine, passed only the
slightest quantity, of the color of brandy; morning
aggravation gradually changing into an evening exacerbation; dizziness on raising herself up; continual
drowsiness; mind dull and wandering during sleep;
pulse 136.
The following remedies relieved, but did not cure the
symptoms appended to them:
Opium: Tongue dry, cracked in the centre; constant drowsiness; tenderness in the left hypochondrium;
want of thirst. Opium also reduced the pulse to 100.
Belladonna, 3 (aided by Chamomilla): Swollen
tongue; drowsiness; suppression of urine. Produced,
also, slight perspiration.




REMITTENT FEVER.               55
Crotalus: Suppression of urine; constant drowsiness.
Stramonium: Swollen, dry, cracked tongue; no desire for water, although her mouth is dry and she has
to moisten it; suppression of urine; lying on the right
side; pain when she lies on the left. (After Stramonium
she could lie on either side.)
Mluriatic-acid, 3: Disposition to slip down in bed;
soreness of the right hypochondrium on contact; swelling of the tongue.
The last and final portrait of the disease was taken October 12th, 1855, and is as follows: Pain and heat behind
both ears and back part of the head; (it was very difficult to discover the nature of the pain and its locality,
as the patient was speechless, very deaf, and almost
blind); deafness, difficulty of speaking; every evening
cold hands and feet; pulse 120; circumscribed redness
on left cheek (the family, on both sides, are consumptive;)
great thirst for cold water, formerly aversion to it;
tongue rough and dry; picking of the nose; great apathy
and restlessness; delirium, wildness, and disposition to
get out of bed; gritting of teeth when half asleep, not
when fully awake. (The gritting of the teeth consisted
in a spasmodic contraction and drawing backwards of
the lower jaw. The mother discovered the true nature
of this symptom by putting her finger in the mouth of
the patient, when she began to bite by elevating the
lower jaw. She has naturally a protruding upper lip
and teeth.) Perverseness, will not take food.
The action of the different remedies during the above
state may be summed up thus:
Iyoscyamu8 had the happiest effect on the gritting




56                   CASES OF
of the teeth, it also improved the tongue and voice
(which was very high pitched and shrill, with much incoherent talk); apathy; pulse went down to 108.
Crotalus and Hyoscyamus: Both were instrumental
in curing the pain in the back of the head. They relieved the difficulty in speaking, picking of nose; partiularly, also, the restlessness, wildness, delirium, and disposition to escape, as well as the gritting of the teeth,
and spasmodic contraction of the lower jaw.
Crotalus alone: The dryness, roughness, and swelling
of the tongue.
Nux-vomica and Arsenic, next to Stramonium and
Hyoscyam. had the best effect in bringing back the
voice.
Arsenicum  caused the appetite to return, and produced sleep at night. After its exhibition the evening
fever receded to one, P. M.
Rlu&s-toxicodendron finally subdued the fever entirely, and removed the redness and dryness of the
tongue.  When, after some time, the redness returned, Oleuqn Jecinoris-aselli had the most permanent
effect. All these remedies were exhibited in the lower
dilutions.
6. Late in September I was called, in consultation, to
see a case of typhoid remittent fever at Frankford, six
miles from Philadelphia. The patient had been treated,
with varying success, by the attending physician, for
two months, the disease returning several times after
weekly intermissions. It had commenced with chills,
a characteristic sore pain from pit of stomach to region
of liver, with qualmishness and nausea, slight delirium,




REMITTENT FEVER.              57
most violent pain in the back of the neck and back on
the least motion. On the first attack the pain was more
in the back of the neck and back, but the second time
it affected more the front and side region of the liver.
Complete sleeplessness.
Crotalu, Horrid., 2, had also, in this case, a decidedly
and immediately beneficial effect: the patient expressing
his feelings about the beneficial action of the remedy.
Subsequently an abscess of the liver formed, which was
successfully treated by Hepar-sulph., 2. The patient
entirely recovered.
7. A remittent fever-in the case of the mayor of a
neighboring town-very similar in its symptoms to the
above, in consultation with another homceopathic physician, was immediately relieved, and finally entirely
cured by means of Crotalus Horridus, 2, in alternation
with Arsenicum. These two remedies very often alternated beneficially in similar cases.
8. In the beginning of this summer (1860) I was
called to see Miss T. E., who had already suffered for
some time with a violent headache and fever, for which
a Belladonna plaster had been prescribed.
This plaster violently aggravated the symptoms, and
she had to remove it. When I subsequently saw her
the following symptoms were noted down: There were
two distinct paroxysms of fever daily, one early in the
morning and the other at seven, P.m. At first these
paroxysms were preceded by slight chilliness, but not
afterwards. The most prominent symptoms accompanying these fevers were violent pain and heaviness in
the bones of the forehead and back of the head; also




58                   CASES OF
throbbing in the vertex, with pain in the back and
region of the liver, followed by a continual yellowishbrown watery diarrhoea. There was also a sensation of
excoriation in the centre of the chest, with coughing
and white expectoration. Complete sleeplessness and
flightiness every night. During the fever the skin was
always dry, with redness of the right cheek, and not followed by perspiration; the tongue was whitish; complete loss of appetite.
As the patient particularly complained about the
headache, and the ordinary remedies, as Belladonna,
Aconite, &c., remained without effect, I gave her the
Veratrum-viride, which relieved the head and somewhat
abated the fever, but only for a short time.
After Crotalus Horrid., 2, in water, the fever, for the
first time, did not return in the morning; the pulse,
which always had been over 130, lowered to 80; perspiration also commenced.  She had the first good
night's rest for weeks, and in less than a week entirely
recovered without any other remedy.
9. The power of Crotalus has been exemplified to me
quite recently in a severe case of bilious remittent fever.
V. A., aged ten, returned from the country on the
twenty-first of July, with a fever, for which Aconite was
prescribed by the mother. As this fever did not yield
to her domestic efforts, I was sent for on the twenty-fifth
of July, when the following portrait of disease presented itself: During the first few days the fever was
preceded by some chills, but not followed by perspiration; afterwards there was only fever, with hot skin,
without the slightest perspiration. There were two de



REMITTENT FEVER.               59
cided paroxysms of fever, one in the morning, about
eight o'clock, and the other from five to seven, P. M.,
which last continued for some time after the morning
fever had entirely ceased. There was also this characteristic symptom, that the patient complained of being
chilly during the fever.
The other symptoms were: Great heat and aching in
the forehead, also pain on the top and back of the head;
the right side of the back of the neck was painful for
a whole week; foul breath; tongue coated yellow,
with enlargement of the papillae; constant thirst for
cold water, with nausea and sick stomach; aching pain
in the region of the liver and stomach; total want of
appetite, even aversion to food; pain in the bones of
both legs, particularly at night; great restlessness and
fretfulness. Aconite, Eupator.-perf., Veratr.-viride, and
Gelseminum semper. had but a slight effect in arresting
the progress of the disease. Rhus-radicans, which was
selected after a careful study of the symptoms, seemed to
mitigate them all; but it did not prevent the tongue
from becoming brown, and afterwards quite black.
There was also sopor, with increase of heat in the forehead.
All these symptoms clearly pointed to Crotalus Hor.,
which was prescribed in the second trituration, and
with its usual happy effect. The sides of the tongue
became moist, the violence of the fever and the thirst
diminished, the sopor also disappeared, and the little
patient asked, for the first time, for some food, which
consisted of grapes and peaches. It should be remarked
here that, from the first exhibition of the Crotalus, five




60          CASES OF REMITTENT FEVER.
or six bilious passages became the order of the day for
a week, after which they subsided. The black coating
on the tongue only very gradually improved. The last
patch was removed by the busy fingers of the little patient herself.-Here was a violent fever, which often
lasts from four to six weeks, entirely cured in fourteen
days!
10. M. H. was lately sent by his father, residing in
Memphis, Tennessee, to this city, in order to be cured
of a very obstinate bilious remittent fever, which the
largest doses of Quinine were only partially able to
subdue.
In the beginning of his sickness there was some chilliness, but afterwards there was only heat every night,
with violent aching pain and burning heat in the forehead, accompanied by nausea. The tongue was coated
yellowish white and was sometimes dry; there was also
considerable pain in the bowels. He had the peculiar
dirty-yellow complexion, and was very much emaciated;
skin dry.
My first prescription was Nux-vomica and Eupatorium-perf., both in the second trituration. His general
health became better, but these remedies were not able
to arrest the evening fever. Crotalus Horridus, second
trituration, three times a day, removed the fever the
second day. His complexion became totally changed,
and he almost looked like a new being. Another
package of Crotalus Horridus, 2, three times a day,
completed the cure, and he returned to Memphis entirely well.




HISTORY OF HUMBOLDT'S INOCULATION.     61
A P P E N D I X.
CHAPTER VIII.
NICOLAS MANZINI7S HISTORY OF THE PROPHYLACTIC EFFECTS OF INOCULATION AGAINST THE YELLOW FEVER,
AS PRACTICED BY ORDER OF THE SPANISH GOVERNMENT AT THE MILITARY HOSPITAL, HAVANA.
THE positive value of Crotalus is further corroborated
by Manzini's history of the inoculation of the venom
of some serpent,* for the prevention of yellow fever, at
Havana, in the year 1854, by a Dr. Humboldt.
In the month of October, 1854, Dr. William Lambert de Humboldt, residing in New-Orleans, wrote to
General Don Jose de la Concha, Governor of the island
of Cuba, that he had discovered a substance which
would serve as a preventative of yellow fever. This
substance, whose principle consisted of the venom of a
serpent, would afford protection against this formidable
disease by inoculation, in the case of strangers visiting
the locality where yellow fever prevailed epidemically.
He had already practiced, in New-Orleans, his inoculation with success, having, during  a period of
* There is now little doubt but that this was the Crotalus Horridus.




62             MANZINI'S HISTORY OF
nine years, inoculated 1438 individuals, of which number only seven were attacked by yellow fever, and two
died.
After a consultation with the medical faculty the
Governor invited Humboldt to Havana, placing a ward
of the Military Hospital under his absolute control.
Mr. Humboldt had hardly arrived in Havana when
Dr. Manzini sought his acquaintance, feeling interested
in a man who, like himself, had made tropical fevers
the subject of his studies. He found Humboldt a man
of about thirty-six years of age, of tuberculous feeble
constitution, but full of fire and enthusiasm for his new
enterprise. Humboldt spoke four languages, but his
medical education, with the exception of his knowledge
of fevers, seems to have been imperfect. He, like
Manzini, believed that the epidemic remittent fevers of
tropical countries and yellow  fever were identical;
they only differed in degree.* Humboldt subsequently
died at Vera Cruz.
Although this discovery is derived from a person
whose identity, according to Manzini, is somewhat doubtful, and whose character is not free from objection, it
may still be, as some other discoveries of doubtful origin, of the highest importance to humanity, deserving
our most serious consideration; the more so if, as Manzini maintains, the inoculation was, on the whole, successful.
Humboldt was led to his discovery by observing that
galley-slaves, brought from Jfexico to Vera Cruz, who had
been bitten by some viper on the way, always had decided
symptoms of yellow fever.
* This is also my opinion.-C. N.




HUMBOLDTIS INOCULATION.         63
To all the inoculated Humboldt administered, at the
same time, a syrup of Mikamia-guaco, the well-known
antidote to all snake poisons. The Spanish Committee
of the University, consisting of Drs. Cowley, Castroverde, and Benjumeda, under the supposition that the
symptoms of the inoculation might be owing to the
syrup of Mikamia-guaco, demanded of him to exhibit the
Guaco separately, and to inoculate, as a counter-proof,
some animals to whom the Mikamia was not administered. This proposition was rejected, on the ground
that the gentlemen of the Committee had no knowledge
of the researches of the two Vargas, Abren de Lima,
Mutis, Bertero, Humboldt and Bonpland, Sigaud and
Rusz, with regard to the pathogenetic and therapeutic
properties of Guaco; that they ignored what was said
of the venom of serpents from Lucian to our times;
and, finally, forget the results obtained by Fontana,
Russell, Blot, Fanau de la Cour, Guyon, and Rusz, from
the inoculation of these poisons into the cellular tissue.
Humboldt likewise declined the proposition of Dr.
Castroverde, to have a certain quantity of the virus diluted, in order to experiment with it according to the
rules of homceopathy.
The news of this inoculation produced a great sensation among the people; they considered it analogous to
vaccination-to the discovery of Jenner-and every one
persuaded himself that some means was now found to
stem the current of this pestilence, and to make these
regions inhabitable for the new emigrant.
Intrinsically considered, the inoculation fulfilled its
promises, and produced phenomena analogous to yellow




64             MANZINI S HISTORY OF
fever, just as vaccination produces symptoms similar to
small-pox. Dr. Manzini relinquished his practice, in
order to devote himself entirely to this " immense scientific question." He himself inoculated some two thousand, and his faith increased every day.
Notwithstanding the inoculation a great number of
the inoculated were attacked by the fever, which was
treated with success, by himself and Humboldt, by his
new (2) method, which consisted: 1. In bleedings from
the feet, to the relaxation of the sphincter-ani muscle;
2-. Large doses of Quinine and Calomel. In the majority of cases the disease was cured in from twelve to
forty-eight hours. Out of three hundred and thirtythree cases of these fevers only one death occurred.
[Might not all these fevers, in a great measure, have
been avoided by a more diluted inoculation, or by administering the inoculating matter internally, in small
doses?-C. N.]
The Asiatic cholera made its appearance in July,
when there were 134 cases; during August there were
252. Dr. Manzini alludes to the intimate connection of
yellow fever and cholera, the second stage of the former
of which often degenerated into the latter. Among
the inoculated the cholera was very rare, the inoculation
acting indirectly as a preservative.
After the cessation of the cholera, in September, yellow fever again made its appearance, but more frequently and with greater severity among the uninoculated than among the inoculated. One cause of the
success of the inoculation not having been so striking he




HUMBOLDT'S INOCULATION.          65
ascribes to the unhealthy position of the Military Hospital.
Mr. Bastareche, the chief military Health Officer for
the island of Cuba, made a report on the inoculation.
According to Manzini, he ought to have been more minute. If his aim was to come to a definite conclusion
he ought to have stated how many soldiers were attacked according to the different periods of their residence at Havana, the influence of a first attack on the
subsequent ones, the extreme limit of the febrile acclimation, the proportion of mortality among those who
had been attacked, the influence of the locality, &c.
For the purpose of arriving at a safe conclusion all these
points ought to have been regarded by Mr. Bastareche.
He did not do so, and contradicted himself in his report.
A month after these experiments had been conducted,
when Dr. Manzini had ceased to be connected with the
Hospital, it was reported to him that there were great
losses among the inoculated, and, at the end of the year
1855, the inoculation was pronounced a total failure.
With regard to the inoculation itself, Mr. Humboldt
gives the following data:
The inoculation has no effect upon individuals who
are acclimated in the places where the yellow fever
prevails. It exerts the greatest power on strangers recently arrived, and according to the susceptibility of
their constitutions to the inroads of yellow fever. In
order to exercise its preservative virtue it is not necessary to produce violent symptoms. With those not
affected by the first inoculation it may be repeated.
5




6 6           MANZINI'S HISTORY OF
There were two phenomena to which Manzini paid
particular attention: the decrease of the pulse and the
heemorrhagic tendency of the gums. He looked upon
this decrease of the pulse as a lowering of the vitality
of the foreigner, placing his temperament in harmony
with the influences of the new climate; in the hoemorrhagic tendency of the gums he saw the pathognomonic
sign of yellow fever. The haemorrhage from the gums
is only the first symptom of the black vomit. On this
account the disease has been compared with the scurvy
by Pouppe-Desportes, Campet, Termin, Dalmas, Valentin, Tood, Chabert, Pugnet, Robert, Keraudren, and
Demadrid.
The first physician who observed this phenomenon of
the gums, and who established it in a memoir on the
subject, was Dr. Francois Xavier Loro, of Cadiz.
It has been supposed that the haemorrhage, swelling,
and inflammation were owing to the almost general use
of Calomel; but it has been observed in many cases
where Calomel was never used, and also long before
the Calomel practice came into vogue. Many other
writers have considered it as a characteristic symptom
of yellow fever, such as Gerardin and Gros, Dariste,
Ardevol, Catel, and Rusz, also Saravesi and Saint Esprit. The latter mentions twenty-two cases, in the
same year (1856), with the haemorrhage of the gums,
none of which proved fatal.
These symptoms of the gums may therefore be considered as the pathognomonic phenomena of the initiatory period of the yellow fever, and, according to Man



'HUMBOLDT'S INOCULATION.          67
zini, the most certain of all, for the black vomit does
not exist in the majority of cases.
In reviewing the whole question, he cites about as
many medical men who do not consider the hoemorrhage of the gums as characteristic of yellow fever as
those who are of that opinion. He himself comes
finally to the conclusion that the inflammation or
haemorrhage from the gums is not a certain diagnostic
symptom of yellow fever, as it is also observed at
the commencement of other diseases, e. g., small-pox,
measles, &c.
The fact is, it seems to me, that a single symptom
cannot furnish a sure diagnosis of any disease. We
must take cognizance of all phenomena in order to form
a correct conclusion.
The symptoms of the inoculation appeared in the following order:
At the moment of the inoculation there was vertigo,
which soon passed away. There was also a nervous
trembling, which is rarer, but which lasts a longer time.
After seven hours the pulse is permanently modified:
it is either too frequent or too slow, stronger or weaker.
In eleven hours there is febrile heat.
At the end of fourteen hours, headache, want of appetite, thirst. At the end of sixteen hours, red countenance, injection of the conjunctiva, epiphora.
The swelling of the gums is observed from the commencement, to which are added slight colic-pains produced by the remedy (Guaco), which the patient has
taken immediately after the inoculation.
1. At the expiration of 18 hours, pain in the gums,




68             MANZINI'S HISTORY OF
the margins of which redden around the teeth; pain
of the salivary glands and in the direction of the different nervous branches of the face and teeth.
2. In 19 hours, pains in the lower jaw and in the
direction of the submaxillary nerve, lassitude.
3. In 20 hours, bitter taste, drowsiness, coryza, and
cedema of the face.
4. In 22 hours, constrictive sensation of the throat,
without a visible alteration of the mucous membrane.
5. In 23 hours, yellow jaundice.
6. In 24 hours, haemorrhage of the gums.
7. In 28 hours, yellowness of the sclerotic coat of the
eyes, shivering.
8. In 29 hours, angina-tonsillaris.
9. In 30 hours, pain in the kidneys.
10. In 36 hours, swelling of the eye-lids.
11. In 38 hours, pain of the muscles and joints.
12. In 40 hours, toothache.
13. In 72 hours, swelling of the lower lip.
At different hours, sensual excitements.
During convalescence, itching of the cuticle, cutaneous
eruptions of various kinds.
SPECIAL OBSERVATIONS OF MANZiNI ON THE SYMPTOMS
OF THE INOCULATED.
As a kind of antidote to the often too great violence
of the symptoms Humboldt administered to his patients, immediately after the inoculation, a syrup, composed principally of the Mikamia-guaco and Rhubarb,
with some Iodide of Potash and Gamboge.*
* The exhibition of such a mixture, as it would materially modify




HUMBOLDT'S INOCULATION.             69
In one case bleeding had to be resorted to.
The inoculated, having a yellow tongue on the fifth
day, had to take Citrate of Magnesia.
The surest antidote to the symptoms of the inoculated was the administration of the Sulphate of Quinine.
PuLsE.-In the majority of cases the inoculation produced a diminution in the frequency of the pulse, and,
what was most remarkable, the sixty-eight who showed
this diminution were precisely those who had the most
frequent pulse before being inoculated, and those who
showed an acceleration had formerly only 69 pulsations
in a minute.  All this can, of course, be explained on
the principle of reaction. According to Manzini, on
giving due weight to both series of phenomena, they
would, on an average, amount to 27 pulsations in a
minute.
This diminution of the frequency of the pulse is the
most common phenomenon of the inoculation, and exists
in proportion to its acceleration as sixty-two to twelve.
The decrease in the force of the pulse is also very
marked. Nearly all cases show at one time a very noticeable feebleness and sinking alternating with its acceleration, each lasting six hours on an average.
HEADACHE.-The headache  is one  of the most
common symptoms of the inoculation.
It lasts, on an average, twenty-one hours.
It can exist without any alteration of the pulse.
the symptoms of the inoculation, was, to say the least of it, perfectly
absurd. If the inoculation acted too powerfully, why was not a
dilution of the matter made with milk, or some other innocuous substance?-C. N.




q0             MANZINIS HISTORY OF
It generally occupies the frontal and orbital region
of the head.
HEAT.-The heat does not seem to be owing to the
increase of the pulse. It was even perceived in those
cases where the pulse sank.
THROAT.-The deglutition was difficult in all cases,
and the tongue was more or less coated.
CUTICLE.-After the cessation of the more acute
symptoms it was very common to witness an itching of
the skin, of which the inoculated complained very
much.
Another group of phenomena constituted the neuralgic pains in the head and neck.
In many cases there were observed erections at night.
NUMERICAL RECAPITULATION.
The circulation was modified in 183 out of 187
Headache had existed in.. 160   "  18T
The face was changed in... 54  "   74
The gums were affected in. 74  "   74
Colics existed in.52  "   74
Swellings of salivary glands in   5  "   74
Pain in the lower jaw present in  10  "   74
Lassitude in.. 59  c"  74
Drowsiness in.10  "   74
Coryza in.16 "  74
Bitter taste in.            54  "   74
Spasm of the throat in..  14  "   74
Jaundice in.16 "  74
Frost in..         13  "   74
Heat in.46  "   74
Perspiration in              17  "   74
Angina-tonsillaris in.     17  "   74
Pains in muscles and joints in   7   "    74




HUMBOLDT'S INOCULATION.                71
The intermittent character of several of the symptoms produced by the inoculation is one of the most
interesting and important points. It is now clearly
established, in the excellent work of the illustrious
Chervin, that the nature of all fevers arising from
marsh miasma is very similar, if not the same.*
NATURE OF THE INOCULATION.
After comparing the analogous effects of the venom
of serpents, as published by various authors, with those
of the inoculated, Manzini finds them very similar. He
does not pretend to say which snake poison Dr. Humboldt used for his inoculation.  It is also strange, although no follower of Hahnemann, that he does not
consider the similarity of action of the poison and the
yellow fever as an objection to its use.
Among the remarkable phenomena cited are several
proclaiming the long continuance of the effects from
the bite. The naturalist Lesneur felt his sufferings for
ten years after having been bitten by a Crotalus Horridus, and H. Cloquet says that men who have been
bitten by a venomous serpent stiffer all their lives.
Koster reports the case of a Negro who was bitten by
a rattlesnake, and experienced all his life pains in the
limbs, which always returned at. the period of the full
moon.t
* This may, perhaps, explain why I have found Crotalus so useful
in certain bilious and remittent fevers.-C. N.
i It will be seen that the above facts correspond with my own
experience, as expressed in a previous chapter, that yellow fever,
ike the effects of Crotalus, may return in the same person a whole




'2             MANZINIIS HISTORY OF
The symptoms produced by these poisons would
have been found still more analogous if their effects
had been observed with more care and accuracy. Manzini quotes from  Dr. Mure's work the pathogenetic
symptoms of the Crotalus-cascavella and Elaps-corallinus, which show great similarity to Humboldt's inoculation.
I.-Results of the Inoculation.
From the foregoing facts the author arrives at the
conclusion that the inoculations produce a portrait of
the principal and most important phenomena of the
yellow fever. These consist of an expression of countenance of a peculiar kind, similar to that of the eruptive
fevers, to which is joined an appearance of drunkenness, particularly shown in the eyes, which are injected;
after which comes the headache and pain in the loins,
the changes in the gums, and, later, the jaundice, the
hbemorrhages, and suppression of urine. These are
among the most constant of the innumerable phenomena of this terrible disease.
To the above we must briefly add the announcement
of Humboldt, that the effects of the inoculation were
more severe in proportion to the elevation of the temperature, and that they were manifested most distinctly
with new-comers. On the other hand, there were some
who felt no effects whatever from  the inoculation.
These consisted of persons who had resided a long time
year after having been subject to the disease, and without being exposed to a fresh infection.-C. N.




HUMBOLDT'S INOCULATION.           t 3
in the country, as well as such as had only recently arrived. They only had a little headache on the
third day, or a slight pain in the loins.
Out of twenty inoculated individuals, who had already been subject to yellow fever, thirteen were attacked by the principal symptoms of the inoculation.
A microscopic examination of the blood taken from
the gums of an inoculated person showed elliptic globules; they were not rounded off, and preserved their
color. Another time, in the urine of another person,
he found them deformed and rounded. It may be observed, however, that this same deformity has been noticed in diseases of an entirely different nature, particularly in Bright's disease.
II.-N-umber of Inoculated Individuals at the Military Hospital, and the conditions of their acclimation
in relation to the time of residence and the diseases
they had undergone.
From  the eighteenth of December, 1854, to the
twenty-eighth of June 1855, 2,477 individuals had been
inoculated: 1214 belonging to the army, and 1263 to
the royal navy.
The conditions of their acclimation, in relation to the
time of their residence in America, were the following:




74               A fNI'S HISTORY OF
TABLE No. I.-LENGTH OF TIME THE INOCULATED HAD
RESIDED IN THE ISLAND OF CUBA.
For 13 years..........                 1
" 11 "......... 2
i" 10.                                1
4c  9  ".                              2
8 C.                              9
7                                  5
t6                                     6
" 5 "........13
"  4  cc                              15
" 3 i"..                            41
2  it"           0   16 0       168
1 year.......... 249
" six months...587
several days...1378
Total.                      2,477
In reference to the febrile diseases with which they
had been attacked before the inoculation, during their
residence in America, the 2,4717 inoculated may be
classed as follows:
TABLE No. II.-NUMBER OF INDIVIDUALS.
Ephemeral fevers.........             73
Intermittent "......... 73
Remittent ".                          33
Cholera-morbus                          5
Small-pox                               3
Acute inflammation with the fever... 25
Total...........212
These 212 diseases have been distributed as follows:




HUMBOLDT'S INOCULATION.               i 5
TABLE No. 3.
Series of 13 years-no disease.
"   11  "   1 intermittent fever.
"'   9  "   1 ephemeral   "
t"    8  "   1 ephemeral and 1 intermittent fever.
it    7  "   1   "          2     "    fevers.
"    5  "   1   "           2     ".
t"    4  "   3   "          3     "       "
",  o3  "  10   "           4     "       "
2  "   8   "          5 
All the other cases of fever took place during the
first eighteen months of the residence of the individuals
in the island of Cuba or in its sea-ports. The 1318
(as mentioned before) only had not been affected with
any disease for several days.
III.-Every one was inoculated, except where the
prodromi of a fever were already present, which falsely
might be ascribed to the inoculation.
A lady with a very painful neuralgia, the remains
of a very pernicious Chagres fever, found herself cured
after the inoculation.
The inoculation exerts an injurious influence upon
the tuberculous. It seems to promote the softening of
the tubercles. In speaking of the nature of the inoculation, hbemorrhage was mentioned as one of the symptoms produced by the bite of venomous serpents.
Dr. Manzini also remembers the case of a mariner,
who, immediately after the inoculation, was attacked
by pneumonia, with an expectoration like dried prunes,
as is the case during mortification of the lungs. He
was sick for a long time, but was finally cured.
In the case of a Sister of Charity, inoculated, there




' 6           MANZINI'S HISTORY OF
was a complete pleurisy, with a fever of a remittent
type.
Nothing, however, was of higher interest than the
fevers from which the inoculated suffered. They resembled yellow fever in its initiatory stage. Nothing
was wanting-expression of countenance, pain in the loins,
headache, the symptoms of the gums; and those fevers
which made their appearance in such an alarming manner
did not last longer, in five out of seven cases, than from
twelve to forty-eight hours. They were all treated by
Manzini, by what he calls his method, which was as
follows: Venesection by the foot until relaxation of the
sphincter-ani. Half an hour afterwards sixty grains of
Sulphate of Quinine and sixty grains of Calomel, in
three packages, one every hour in black coffee. The
Sulphate of Quinine to be continued in the same dose
every two hours during the intensity of the fever; an
emollient enema, every six hours, of knot-grass water
(polygonum ariculare); finally, the headache and pain in
the loins was combatted by scarifying cuppings, and the
Calomel repeated. The repetition of the general bleeding is to be avoided when it continues to rain much.
Notwithstanding this absurd treatment, the success
of the inoculation, if we may believe Manzini, was
quite favorable. But I must again aver my opinion
that, if the inoculating virus had been exhibited internally in a small dose to the unacclimated, as a preventative, the symptoms of yellow fever would have
been much milder, and not have required the violent
and active medical treatment described above.
Be that as it may, out of the 701 inoculated at the




HUMBOLDT'S IN OCULATION.             77
Military Hospital, 121 were pronounced as having been
attacked by yellow fever, of which 47 died. This is
the report of the committee appointed by Mr. Bastereche in behalf of the Government.  The chairman of
this committee was Mr. Gutierrez, sometimes Mr. Benjumeda. According to Manzini, the remaining 580 cases
had also symptoms of the fever, which fully entitle them
to be ranked among the yellow fever cases. They were
placed under the influence of Quinine, and rarely lasted
more than forty-eight hours. They very much resembled in their character the remittent fevers to which
the Creoles or old colonists are subject who remain free
from yellow  fever.  "Sirnilia Similib6u  C(urantur."C. N.
These sudden and complete cures in so large a number
were certainly a new feature presenting itself to our observation. The entire removal of remittent, as well as yellow
fevers, by means of any treatment, although we do not
pretend to call it impossible, is still a very rare occurrence. On the other hand, it is more common to see the
fever progressively increased by any violent treatment.
He quotes some authors who maintain the possibility of
arresting the progress of the disease by bleedings and
other means.  Such are Thomas,* O'Halloran,t Cate].$
The father of medicine observed that the progress of
acute diseases could be arrested by bleedings. It is a
pity, says Houdart,~ that he never thought of doing so.
* "Fievre Jaune d'Amerique." Paris, 1823, p. 82.
t "Aperpu Succinct de la Fievre Jaune." Paris, 1824, p. 105-8.
$ Chervin, " Identite," &c., (Bulletin de l'Acad., T. VII., p. 1114.
O "Etudes sur Hippocrate." 2me Edition. Paris, 1840.




78             MANZINImS HISTORY OF
If Fuster remarks that he has never been able to arrest
the winter fevers of the Torrid Zone, he only admits the
insufficiency of his therapeutic method.
But, continues Manzini, in the case of the inoculated,
it was not a progressive diminution-a slow killing of
the fever-which we observed; it was a complete destroying of it (jugulation), in the whole force of the
word, as we have never observed it with the unacclimated, in consequence of which five hundred and eighty
cases of fever, which had manifested themselves with
all the violence of yellow fever, were promptly reduced
to the proportions of simple ephemeral or prolonged
fever. This result was owing to the inoculation. It furnished to Manzini's mind the method by which he could
calculate the proportion according to which the unacclimated arrived at the point of complete acclimation
under the influence of this operation.
There is also a fact which corroborates his view:
this was the absence of all ephemeral fevers in former
years at the Military Hospital. On the other hand;
Manzini quotes numerous authorities, according to whom
there marches along with the regular yellow fever epidemic one of a more ephemeral and milder character.
The truth with regard to this question may be stated
as follows: The first attack of fever is generally the
most severe and dangerous. The ephemeral form seems
sometimes sufficient to harmonize the constitution with
the new climate, although very often it indicates that the
subject will have very rude and frequent attacks to
submit to before he arrives at this result.
In resuming, Manzini proclaims the following incon



HUMBOLDT'S INOCULATION.           T9
testible fact, that inoculation serves the same pur9pose as
acclimation.
These generally ephemeral and sometimes remittent
fevers were, according to his conviction, modified yellow
fevers, which on no consideration ought to have been
separated from the 70 cases which did not present
the characteristic hemorrhage. For, notwithstanding
this fact, the committee had classed them among the
121 cases of yellow-fever, and by the side of the 51
affected with the haemorrhages.
The moment has now arrived to demand the cause of
such exclusion, and to demonstrate that nothing could
authorize the admission of the 70 cases to be considered as yellow fever, to the exclusion of the 580 of
which the committee took no notice whatever.
Is it, Manzini asks, because the majority of these
cases have only lasted five days? That could not be the
case, because Mr. Bastareche has pronounced the case
of General Concha to be yellow fever (in the Gaceta de
Habana), although it lasted only twenty-four hours.
If they pretend to diagnosticate the disease by the
number of days elapsed, the case of an inoculated lady
may be mentioned, which the president of the commission, Mr. Gutierrez, pronounced to be' yellow fever,
which was restored in five days. Subsequently, the
lady was again attacked, and died of the disease.
In resuming, it may be mentioned that the 701 cases
of fever among the inoculated were all cases of yellow
fever, if we admit that the diagnosis can be established
without having recourse to the haemorrhage characteriz



80             MANZINI S HISTORY OF
ing it. In the contrary case, there were only 51 cases,
of which 47 died.
DIAGNOSIS.
After innumerable quotations fiom all the writers on
yellow fever, Manzini asks the significant question:
What are the definite characteristic diagnostic symptoms of yellow fever? All the authors answer him that
the jaundice and black vomiting constitute the l'tendard or the signals of yellow fever, just as the bubo and
partial mortification form those of the plague.
Very truly he says: Of what advantage is it to characterize a fever in its initiatory stage with a phenomenon
which only appears at its close? The same remark
applies to another phenomenon-the jaundice-which
only begins to appear on the third or fourth day.
In this way you could not diagnosticate the fever
until the third or fourth day, because these signs do not
commence to appear before that time. Finally, the
icterus appears, and then it is said, this is yellow fever.
Is that so certain, continues Manzini; has not Bontius proved that it accompanies all acute maladies in
the Torrid Zone?*  Savaresi, has he not affirmed the
same after him? (p. 76.)
Pouppe has observed it at Saint Domingo in the
double tertian (VI., p. 44).  Campet has observed it
in Cayenne, as generally characteristic of the same
disease, and has seen it twice appear in the rare form of
a complete yellowness (pp. 126, 130, 136). Savaresi
* "Med. Ind.," Chap. X.




.HUMBOLDT'S INOCULATION.              81
has observed it in Martinique, in remittent, intermittent, and nervous fevers (p. 251).  M. Catel in the
intermittents of this same Antilles.*  M. Rochoux, at
Guadeloupe, in the gastric inflammatory fever.t  Dr.
W. Parry in the remittent fever. M. G. Douglas Dods
has made the same observation at Demerara, in the
same way as Drs. Damill and Edw. Bradford have in
several of the Antilles of the western coast of Africa.+
Mr. Levacher, finally, has observed it in the double
tertian of St. Lucia (p. 130).
Wherever yellow  fever prevails epidemically, no
doubt jaundice is often present; but, in order to come
to the truth with regard to its diagnostic value, we must
mention that certain physicians consider it an uncertain
unreliable pathognomonic symptom. Of this number are
Lind,~ Arejula (p. 184), Gilbert (p. 76), Pugnet (pp.
359, 380), Audonard (pp. 67, 68), Caillot (p. 176),
Ranul,I Chabert (p. 13), Devize (pp. 34, 36), Ande'vol
(p. 116), Dariste (p. 134), Levacher (p. 88), and Moreau de Jonnes.
Manzini is of opinion that yellow fever is best characterized by hemorrhages,.sui generis; but, as he
himself confesses that this phenomenon is not present
in the slighter cases, we come to the inevitable homceopathic conclusion that the whole ensemble of all the
* Chervin, " Bulletin de l'Academie de Med.," Vol. VII., p. 1110.
t " Rech. sur la Fi6vre Jaune," pp. 221, 251.
X " Second Rapport," pp. 320, 328, 331, 340.
~ "Mal. des Europeens." Paris, 1785. -Vol. I., p. 171.
II Mr. O'Halloran. pp. 205, 206.
6




823     ~HITSTORY OF HETMBOLTDT'S INOCULATrION.
symptomls clonstitute the true characteristic of yellow
fever.*
The above facts show  that there exists a strong
lrsemblance between the intermittent, remittent, and
other fevers of tropical climates; that, in fact, they are
only manifestations in different degrees of the same
miasmatic virus. The same homceopathic remedies will
subdue them.
Finally, the work winds up with a severe criticism of
Mr. Bastareche's report to  the  Government.   This
gentleman, it seems, has not done justice to the inoculation, as has been pretty clearly established by the
minute analysis of his report.
If we again impartially review AManzini's whole account
of the inoculation, we must come to the conclusion that
it has in some measure been successful.
This whole question deserves our most serious consideration, and we particularly call upon all physicians,
who have the opportunity, to investigate the action of
Crotalus in epidemic yellow and malignant bilious fevers. It is only after repeated trials that we can arrive
at a final solution of the subject.
* Mr. Claude Bernard, in his "Lectures on Experimental Pathology," makes the following observation: "We must bear in mind
that a disease is not characterized by a single symptom; it consists
rather of a complete series of symptoms, standing to each other in
the relation of cause and effect."-C. N.




NINE NEW CASES
OF
REMITTENT FEVER.
I. Miss M. S., aged twenty-two, was afflicted in the summer
of 1861 with a bilious remittent fever, which was cured in a
few days by the adm'iistration of Crotalus Horridus 3, in
water, a teaspoonful every two hours. She received no other
remedy. Crotalus acted like a charm. The symptoms, as I
noted them down at the time, were the following: chilliness,
alternately with heat; occasionally sudden cold perspiration;
pulse full, and 100 in a minute. The eyes were sunk, with a
dark-brown ring surrounding them; tongue dry in the centre, and yellow; the point red; constant vain efforts to evacuate the bowels; nausea and sick stomach. The passages
are only slight, of a black color, and pappy consistence; soreness in chest and stomach; pain on touching them. She cannot lie on the left side. Great drowsiness all the time, and
excessive weakness.
II. Mrs. O., aged seventy-one. Has two paroxysms of fever
every day, with the pulse 120. (The administration of Crotalus brings the pulse down to a 100 on the first day.) The
disease had lasted six weeks, and although various remedies
were resorted to, Crotalus-horridus 3, in water, always had
the best effect. The following symptoms were the most prominent; skin dry, afterwards cold perspiration; very thirsty;
takes a little water at a time; burning heat on top of the head;
heat in both cheeks, with redness; light-headed; eyes sunk;




84                 NINE NEW CASES OF
tongue coated yellow, and dry; bitter taste in mouth; soreness and dryness of throat, which presents a dark-red appearance; hawking up of greenish yellow phlegm, with sweetish taste; sick stomach after eating, with vomiting and purging, slight pain in the region of the liver; dark-brown diarrheea; wakefulness. This disease was entirely cured by Crotalus-horridus, aided by Baptisia-tinctoria.
After having the disease so severely, it returned a year
afterwards in a milder form, and was cured by the same remedy.
The symptoms were very similar, with the exception of a
cough, which was cured by Laurocerasus.
III. A homceopathic physician in the country reported to
me the following case of bilious vomniting, which was entirely
cured by Crotalus in the 5th dilution. The case was of thirteen weeks standing, and had been given up by the old school.
Symptoms: She could not lie on the right side nor back without instantly producing dark-green vomiting; soreness in the
back part of the head, on pressure, worse on motion or sitting
up in bed; drawing in the right side of the head, worse after
eating, and producing great dizziness in the back part of the
head. She sleeps only in the middle of the night, after which
she feels better. She feels sick if she sleeps in the daytime.
Light hurts the eyes, and everything looks yellow, (at first
everything looked blue to her). Aching in the liver; great
heaviness in the stomach, with vomiting of everything she eats
in the morning. She can eat better in the afternoon, and she
feels sometimes as if she could eat fat pork. A continual acid
taste on the tongue; inclined to be constipated; menses too
early, and too sparse; they are dark at first; roaring in the
ears; great numbness of arms and legs, with coldness at times;
skin very dark-brown. After the first dose of Crotalus 5, she
vomited but once, and was able to be out of bed in one week.
IV. Mrs. M. S., aged sixty-nine, was cured in a few days,
by Crotalus 3, of a severe bilious fever, with the following
symptoms: Chills in feet and hands, followed by heat in the
head, which ached before; mouth dry; very thirsty; foul




REMITTENT FEVER.                  85
breath; heat and redness in the right cheek; on closing eyes,
wandering of mind; yellowish color of the face; sensation of
excoriation of the stomach, with soreness of touch; complete
want of appetite; eructations of wind; gnawing aching pain
in the liver; sanguinolent discharges from the bowels. In addition to the above she was also afflicted with hepatization of
the right lung, and consequent shortness of breath, always expectorating much yellow phlegm, after severe hard cough, and
soreness on the left side. The effect of the Crotalus was assisted by the exhibition of Baptisia-tinctoria. The cough was
cured by cod-liver oil.
V. Lieutenant W., of Commodore Wilkes' expedition, consulted me, quite lately, in his case of yellow fever, which he
had contracted on the coast of Cuba. Although much diminished in violence, it never ceased entirely, notwithstanding
numerous powerful remedies had been exhibited for six weelks,
until he took the Crotalus-horridus 3, in water. In two days
after, a slight aggravation, the fever was arrested. He considered this effect so remarkable that he mentioned it to everybody. In order to break the fever, he had received Quinine
in thirty grain doses, repeatedly, also Calomel. Finally,
Nitro-muriatic-acid, but without avail. He did not improve
until he reached a colder latitude, and his fever was not arrested until he took the Crotalus.
VI. Miss V. Headache with high fever, mostly at night,
with great drowsiness; aching in all the bones; heat in forehead; the slightest motion hurts the head; burning in the
chest. Crotalus-horridus 2, cured, after Aconite and Belladonna had been administered in vain.
VII. Mr. M., went with the volunteers into Maryland, and
was encamped on a small stream. Returning soon after he
was attacked with a bilious fever, with the following symnptoms. Bilious vomiting, with violent fever and delirium, entire forgetfulness of everything; dullness of the head with
great apathy and fretfulness; everything tastes bitter, and




86                NINE NEW CASES OF
sometimes acid; finally, very fretid diarrhea; tongue dark
brown; constant drowsiness; dryness of the skin; (for these
last three symptoms Crotalus is particularly indicated,) urine
high-colored. When the crisis took place after Crotalus, there
was a warm perspiration. Two days after commencing the
Crotalus the brown color from the tongue gradually disappeared, and lie had several green watery passages, always a
very favorable symptom for the speedy cure of these fevers.
VIII. Mr. A. M. Chilliness every afternoon; a kind of
crawling up and down the back, and afterwards all over, for
five or six hours; severe pressure on the top of the head, running to the ears, with light-headedness and confusion, and heat
from the head to the feet; shooting pain from the occiput
down the spine and arms; foul breath; tongue coated yellow;
bitter taste in the mouth, and nausea; soreness to the right
side of the pit of the stomach, through to the shoulders; aching in the middle of the chest, to the back; dull pain across
the hips, and also in the back and left shou4der; constant inclination to stool, with dark-brown blackish discharges. Crotalus 3, at once cured all these symptoms.
IX. Dr. W. Jackson Simon of Philadelphia, reported to me
the following case of a cure of bilious fever with Crotalus,
which I will give in his own words:
Having lost my notes, taken during the illness of Mr. Wm.
W., I will have to depend on my memory for a statement of
his case. Oct. 5, 1860, was this day requested to visit Mr.
Wm. W., aged twenty-eight years. Constitution remarkably
good. Had never been sick, until two months previous, at
which time he was in the West, and had fever and ague. Temperament bilious sanguine. I found him complaining of severe frontal headache, and alternate chills and heat. Tongue
furred white, the tip and edges scarlet red, pulse full and
strong, about 140 per minute. Complained of some soreness
of the abdomen on pressure, but none when that was removed.
I prescribed Aconite and Rhus-tox., for some time, but without any improvement. Other remedies were given as the




REMITTENT FEVER.                  87
symptoms indicated, but all failed to relieve him. On the
21st day of my attendance, finding the patient much worse, I
called Dr. J. G. Howard in consultation. We used a number
of remedies, but without any apparent benefit. His condition
at this time was as follows: tongue dry and cracked; darkbrown streak down the centre: the edges of a deep red color;
occasional bilious discharges; no appetite; a cold clammy
perspiration on the forehead and temples; skin yellow. Would
speak when roused by shaking, seemed entirely unconscious
of everything. Urine of a dark-red color, depositing a dark
yellowish red sediment. Pulse 50, weak.
As his mother was a widow, and he her only son, I felt extremely anxious to save his life. While on a visit to Mr.
Radde's store to purchase medicines, a new work was handed
me, " On Crotalus in Fevers," by Dr. Neidhard. In glancing
over it, I saw several cases given, corresponding in symptoms
to IMr. W's case, in which the author had used Crotalus with
great success. I asked Mr. Radde if he had any that was reliable. He said no, but thought he could get some from a
physician just from Havana. I waited about two hours when
he returned with a drachmn vial of the third trituration. I immediately returned to.my patient, -and informed his mother
that I had something which I hoped would relieve him. If it
did not, I could do nothing more. I left five powders containing one grain each, directing one to be given every three hours
until, all were taken. On my visit the next morning I found
my patient conscious, and wanting something to eat. The
medicine was continued every six hours, for three or four days,
when the patient being able to sit up, it was discontinued. In
ten days he was able to attend to his business.
In conclusion I will remark that I have since used this remedy
in typhoid and bilious remittent fevers with marked success.




Just Published:
DIPHTHERIA,
AS IT PREVAILED
In the United States from  1860 to 1867, preceded by an Historical Account
of its Phenomena, its Nature and Homoeopathic Treatment,
BY
C. NEIDHARD, M.D.
Price, bound,       -      -      -     -      -      -      -      $1.75
After the publication of several able works on diphtheria by the Homceopathic Press, it might be considered superfluous to issue another work
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The author's own rich experience (having attended over six hundred cases
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Hill's  Epitome...................................................,    50
Hitehman, Consumption........................................... -  75
Holcombe, Yellow Fever.............................-  38
do    What is Homceopathy?..                                       -  10
do    How I became a Ioomceopath............................. -  20
Homceopathic Cookery............................................,  50
Hufeland, Enchiridion Medicum...................................  2 50
Hall's Life of Hahnemann......................................... -  38
Hull, The homceopathic Examiner, 2d and 3d volume, bd............. 10 00
Hull's Jahr Symptomatology..........                                    6 00
do  Repertory.............................................   4 00
Humphrey, Dysentery.........,..............................    50
do on Cholera......                               - 38
Hydriatics, or Manual of the Water Cure...............-.........,   50
Jahr's Diseases of the Skin........................................1 50
Jahr & Gruner's Pharmacopoeia....................................  3 00
Jahr's New Manual, by Hempel, in one volume.....................  4 50
do  Diseases of Females.........................................2 50
Joslin, Principles of Homcopathy............-.......... - 75
do  Homoeopathic Treatment of Cholera..........................1 00
Kreussler on Acute and Chronic Diseases.......................... -  75
Laurie's Homceopathic Domestic................................    60
do    Appendix to Domestic Practice.............................  1 25
do    Elements of Hornm. Practice of Physic........................  4 00
do    Parent's Guide...........................................  1 00
Lazarus, Iiomceopathy............................................ -  38
Lippe, Text Book of Materia Medica..............................   6 00
Lntze's Theory and Practice.....................................  2 50
Madden's Uterine Diseases..................                    50
~~~~~~~~~~~~~~~~~~~~~~~~~~50~




90
Malan's Family Guide.........-.................                                    30
do           do      in Spanish...............................,, 75
Marcy, Homceopathy and Allopathy...............................,  -  50
Marcy & Hunt's Theory and Practice, 2 vols.........................,           12 00
Materia Medica of American Provings...................1.........  1 00
Metcalf,  Homceopathic Provings...............................,,.  1 50
Millard, Consumption............................................ -  75
do    Guide for Emergencies......................... -  50
Minton, Diseases of Women and Children............................  3 50
Morgan on Indigestion, Constipation, &c...........-   75
Mlunde on Scarlet Fever..................-............... 50
Mure's Materia Medica.......  1 00
Neidhard on Crotalus Horr. in Yellow Fever..........................,.  75
do  on Diphtheria (in press).
New Provings of Cistus can, Cobaltum, Zingiber, &c.................  -  75
North American Journal of Homceopathy, per volume.4 00
Oehme, Domestic Physician........................................    60
Peters on Headaches and Diseases of the Head.,. 3 00
do  Apoplexy............,...............,.,.    1 00
do  Diseases of Females and Married Females..................,.  1 50
do  Diseases of Married Females.................................   1 00
do  Principal Diseases of the Eyes...............................  1 50
do  Internal    do                do........................,              1 00
do  Diseases of the Brain.......................................  1 00
do  Nervous Derangements....................................  1 00
do Principles and Practice of Medicine........,,,.. 3 50
Practical Guide..........,.....................   -  20
Pulte's Domestic Physician.......................................  3 00
do  Woman's Medical Guide.....................................  1 50
Philadelphia Journal of Homceopathy, 4 vols., bd....................  8 00
Itapon on Typhoid Fever.......................................... -  50
Ran's Organon...... 1 25
Reil on Aconite...................................................  --  75
Rokitansky, Pathological Anatomy........................,,,,..                   75
Rneckert, Therapeutics.............,,...........................  4 00
Ruof's Repertory....................... 1 50
Rush's Veterinary................................................-  50
Sehaefer's Veterinary Homceopathy................................  2 00
Sharp's Tracts, 12 numbers.............,,.............. -  75
Smalls Diseases of the Nervous System.............................  1 00
do  Homceopathic Practice......................................  3 00
do        do             do  German Edition........................  3 00
do  Pocket Manual.............................................. -40
do   do   German Edition.......- 40
Stapfs Additions to the Materia Medica............................  1 50
Tarbell, Homoeopathy Simplified....                              1 25
do    Sources of Health........................................    -  50
Ten Reasons for Preferring Homceopathy............................ -  05
do             do          do        German Edition............   -  10
Tessier on Asiatic Cholera.........................................  -  75
do   on Pneumonia.............................................   -75
Teste, Diseases of Children........................................    1 50
Vanderburgh, Appeal for Homceopathy.........................                         15
Williamson, Diseases of Females and Children...................                  1 00
Wolf on Apis-Mellifica......................................, -25
PERIODICALS.
North American Journal of Homceopathy, quarterly,..........per year $4 00
Hahnemanian Monthly............................................  3 00