Lachesis is a frequently indicated remedy, and one that you will need to study much in order to know how to use.

  

"Materia Medica by James Tyler Kent

The Materia Medica by James Tyler Kent was written in 1905. 

Lachesis is a frequently indicated remedy, and one that you will need to study much in order to know how to use. Lachesis seems to fit the whole human race, for the race is pretty well filled up with snake as to disposition and character and this venom only causes to appear that which is in man.

We will first give a survey of the general symptoms, those which characterize the remedy and are of greatest importance, and the circumstances under which the symptoms appear, are brought out, or are aggravated.

One who is a constitutional Lachesis patient will find himself suffering from an aggravation of his symptoms in the Spring, when he goes out from the cold weather into the milder weather, and especially is that so if it is mild and rainy, or cloudy weather. Or if he goes from a cold into a warmer climate the symptoms of Lachesis will come out. The warm south winds excite the Lachesis symptoms.

The symptoms of Lachesis are worse on entering sleep. He may have felt nothing of his symptoms when awake, but when sleep comes on they are aroused, and they gradually increase as the sleep is prolonged, so that a very long sleep will aggravate all the state and condition of a Lachesis patient, and when awakening from sleep he looks back upon that sleep with sorrow.

The sleep has been disturbed by attacks of suffocation and by awful dreams, and now, after having slept a long time, he arouses with dreadful headaches, with palpitation, with melancholy, with sorrows from head to foot. His body is full of suffering and his mind sees no brightness in anything. There is a cloudy state, sadness, melancholy, insane notions, whims, jealousy and suspicion.

When taking a warm bath, or applying warm water to places that are inflamed, his mental symptoms are aggravated. After a warm bath or after getting warmed up, or, if he becomes chilled from being out on a cold day and then goes into a warm room the symptoms come on. After going into a warm bath, palpitation comes on; it seems as if his head would burst, his feet become cold, and he is shocked all over, pulsation all over, or feeble heart. Fainting in a warm bath. Girls sometimes faint when going into a warm bath. The patient may be cold and chilly yet the warm room increases or brings out the symptoms.

The general aspect of the patient and the localities will point sometimes to Lachesis. Upon the face there is an appearance of anxiety, of unrest and distress. The face is spotted or purple and the eyes are engorged. 

The eyes look suspicious. If there is an inflamed spot, it is purple. If there is an inflamed gland, and Lachesis is full of inflammation of the glands and cellular tissues, there is a purple or mottled appearance. If there is an ulceration the ulceration bleeds black blood, which soon coagulates and looks like charred straw. From the wounds there is much bleeding. 

Small wounds bleed much like Phosphorus and Kreosote. A prick of a pin will ooze great drops of blood. Ulcers eat in, have false granulations, are putrid, bleed easily, and the blood is black, and all round the ulceration there is a purple, mottled appearance, looking as if about to become gangrenous. Often gangrene does come; gangrene of parts that have been injured. Sloughing with great offensiveness. The parts turn black and slough. The veins become varicose. These are found upon the limbs, having the appearance of the varicose veins that come after gestation. Enlargement of the veins is a prominent condition of Lachesis.

From the slightest exertion of the mind or from the slightest emotion the extremities become cold, the heart becomes very feeble, the skin is covered with sweat and the head is hot. Warmth does not seem to relieve the coldness of the feet and hands; they are so cold. They may be wrapped up in flannels and still they remain cold, but the patient has an aversion to heat; aversion to a warm room, because suffocation is brought on. He cannot breathe and wants the windows open. It is weakness of the heart; sometimes so weak that it can hardly be heard or felt, and the pulse is feeble and intermittent. At other times there is audible palpitation of the heart.

As we go over the symptoms of the text we will notice something singular about the complaints, that is, their tendency to affect the left side, or to begin on the left and extend to the right. The paralysis begins by gradually appearing weakness upon the left side. Which extends to the right side. It has a strong affinity for the ovaries, and in-this it will be found that the left ovary is affected first. 

So, in inflammation of the ovaries, the left will be affected first, and later the right. The inflammation begins on the left side of the throat and gradually goes to the right. The left side of the head is commonly most affected. The left eye becomes painful and the pain extends to the right. The left side of the back of the head, in the occipital headache, will be more affected than the right. This does not always follow, and if the reverse is true it does not contra-indicate Lach., but such is the common feature of it. Left upper and right lower, has been observed.

In many symptoms of Lachesis, there is morning aggravation. This is the well-known Lachesis aggravation after sleep; the patient will sleep into the aggravation. In the milder symptoms this aggravation is mild and is not felt until after the patient wakes up from a long sleep, but if the aggravation is one that is of considerable violence, the patient may feel it immediately on going to sleep, and it arouses him; for instance, the heart symptoms. As soon as he goes into a sleep he rouses up with palpitation, with dyspnoea, with suffocation, with exhaustion, with vertigo, with pain in the back of the head, and many other circulatory disturbances.

The next most important thing to be studied is the mental state. Nothing stands out more boldly than the self-consciousness, the self-conceit, the envy, the hatred, the revenge and the cruelty of the man. These things, of course, are matters of self-consciousness, an improper love of self. Confusion of the mind to insanity. All sorts of impulsive insanity. The mind is tired. The patient puts on an appearance like the maudling of a drunkard, talks with thick lips and thick tongue, blunders and stumbles, only partly finishing words; the face is purple and the head is hot. 

There is choking and the collar is uneasy about the neck; and the more uneasiness about the neck, the more choking, the more confusion of mind and the more appearance of intoxication. You will see if you talk with one who is intoxicated with whiskey symptoms like Lachesis, he stumbles through, hardly realizing what he says, half finishing his sentences and his words, leaving his "g's" off all the present participles; he stumbles and blunders, he mutters, and tells you first one thing and then another. These symptoms are increased under the circumstances mentioned, in the Spring; in the warm weather following a cold spell; in rainy weather; after a warm bath; after sleep. 

The mental state is large. Jealousy without any reason. Unwarranted jealousy and suspicion. Many times this medicine has cured suspicion in girls, when they were simply suspicious of their girlfriends. She never sees a whispered conversation going on but they are talking about her, to her detriment. Suspects that they are contriving to injure her, and she will resort to any scheme to see if they were not talking of her to her detriment. A woman imagines that her friends, husband, and children are trying to damage her; that her friends are going to put her in an insane asylum. 

Apprehension of the future. Thinks she is going to have heart disease, and is going insane, and that people are contriving to put her in an insane asylum. Imagines her relatives are trying to poison her and she refuses to eat. She thinks sometimes that it is only a dream and she can hardly say whether she dreamed it or whether she thinks it. She thinks she is dead, or dreams that she is dead, and in the dream preparations are being made to lay her out, or that she is about to die.

Thinks she is somebody else, and in the hands of a stronger power. She thinks she is under superhuman control. She is compelled to do things by spirits. She hears a command, partly in her dream, that she must carry out. Sometimes it takes the form of voices in which she is commanded to steal, to murder, or to confess things she never did, and she has no peace of mind until she makes a confession of something she has never done. The torture is something violent until she confesses that which she has not done. Imagines she is pursued. Imagines that she has stolen something, or that somebody thinks she has stolen something, and fears the law. She hears voices and warnings, and in the night she dreams about it. The state of torture is something dreadful, and it then goes into a delirium with muttering. The delirium is carried on like one muttering when drunk. This state increases until unconsciousness comes on and the patient enters into a coma from which he cannot be aroused. The patient also goes through periods of violence and violent delirium.

It is full of religious insanity. You will find a dear, sweet old lady, who has always lived what would be called an upright and pious life, yet she is not able to apply the promises that are in the Word of God to herself; these things seem to apply to somebody else, but not to her. She is full of wickedness and has committed the unpardonable sin. She is compelled to say these things; she is overwhelmed by these things and she is going to die and going to that awful hell that she reads about. The physician must listen to this with attention. The physician might make the mistake in this instance of making light of such feelings. If he does, the patient will not return, and he will be deprived of the chance of benefitting her. No matter what her whims are, no matter what her religious opinions are, her state of mind must be treated with respect. It must be treated as if it were so.

She must have sympathy and kindness. It is an unfortunate thing for a doctor to get a reputation of being an ungodly man, among pious people, as he will be deprived of doing these people an immense amount of good. He must be candid with all the whims and notions of the people that he visits in the world. He must be everybody's friend, and he can be such without any hypocrisy if he is simply an upright and just man.

The state of religious melancholy, with religious insanity, is not uncommonly attended with much loquacity, with talkativeness, which Lachesis is full of. It is commonly among women, very seldom among men, that we find this religious melancholy. Now, this woman is impelled to tell it; she will annoy her intimate friends, day and night, with this story of the damnation of her soul and her wickedness and all the awful things she has done. If you ask her what things she has committed she will say everything, but you cannot pin her down to the fact that she has killed anybody. If you allow her to go through with her story she will tell you all the crimes in the calendar that she has committed, although she has been a well-behaved and well-disposed woman. There is another kind of loquacity belonging to Lachesis. 

The patient is impelled to talk continuously. It is found in another state in which the patient is compelled to hurry in everything she does, and wants everybody else to hurry. With that state of hurry is brought out the loquacity, and this is something far beyond comprehension until you have once heard it. There is no use attempting to describe it, it is so rapid, changing from one subject to another. Sentences are sometimes only half finished; she takes it for granted that you understand the balance and she will hurry on. Day and night she is wide awake, and with such sensitiveness to her surroundings that you would naturally think, from what things she hears and how she is disturbed by noise, that she can hear the flies walk upon the walls and the clock striking upon the distant steeple. You do not get all these things in the text, you have to see them applied. 

But the things I give you that are brought out clinically are those things that have come from applying the symptoms of the remedy at the bedside to sick folks. "Most extraordinary loquacity, making speeches in very select phrases, but jumping off to most heterogeneous subjects." "One word often leads into the midst of another story." These states may come on in acute diseases like typhoid, when it _will take the usual typhoid delirium, or they may come on in conditions like diphtheria, or in any of the diseases that are characterized by blood poisoning; they may come on in the puerperal state, or may take the form of insanity. It is a long acting remedy, and if it has been abused its effects will last a life time.

In many cases a close connection between the mental symptoms and the heart symptoms will be noticed, especially in young women and girls who have met with disappointment, who have been lying awake nights because of disturbance of the affections, or from disappointment, or from shattered hopes, or from grief. Prolonged melancholy, mental depression, hysterical symptoms, weeping, mental prostration and despair, with pain in the heart, with a gone sensation or sensation of weakness in the heart, with difficult breathing. She meditates upon suicide, and finally settles back into an apathetic state, in which there is an aversion to everything, to work, and even to thinking.

I might impress upon your mind the head symptoms if I related the case of a patient who described her symptoms probably more typically than you can find in the books. She was sitting up in bed and unable to lie down; she was worse from lying down, her face was purple, her eyes were engorged, the face puffed and tumid and the eyelids bloated. She sat there perfectly quiet in bed and described the pain as a surging sensation, which came up the back of the neck and head and then over the head. That is a typical feature of Lachesis. 

A surging in waves. Waves of pain that are not always synchronous with the pulse. They may not relate to the flow of blood at all. The surging is aggravated by motion, not so much in the act of motion, but after moving. It is sometimes felt after walking or changing to another place, and sitting down again; that is, a few seconds after the motion is completed the pain begins, and it comes to its height instantly and then gradually subsides into a very steady surging or a more steady ache. In the head there is a continuous steady ache, which may be aggravated or aroused into a surging which is so violent that it seems as if it would take the life of the patient.

The headache begins in the morning on waking. The milder Lachesis headaches begin in the morning on awaking and wear off after moving about a while. With the headaches and complaints in general there is a momentary vanishing of thought; all sorts of vertigo. Vertigo with nausea and vomiting. The vertigo inclines the patient to turn to the left.

Lachesis has bursting pains in the head; congestive pains with a feeling as if all the blood in the body must be in the head, because the extremities are so cold and the head pulsates and hammers. This pulsating headache is part of a general pulsation from head to foot. In all arteries and inflamed parts, there is pulsation. The inflamed ovary pulsates, and it feels at times as if a little hammer were hammering upon the inflamed part with every pulsation of the artery. 

Lachesis has a number of times cured fistula in ano when associated with this feeling as if a hammer continually hammered the little fistulous pipe. It has cured fissure of long standing when it felt as if the inflamed part were being hammered. Haemorrhoids have been cured when this sensation of hammering was present. So that we see this pulsation in the head is not a special symptom, but is a general symptom, brought out in relation to the head.

Some symptoms are valuable because of the frequency of their association, and when such is the case their concomitant relation becomes important. The cardiac symptoms are frequently connected with the headache symptoms in Lachesis. It is seldom that you will see Lachesis headaches without cardiac difficulty. A weak pulse, or the pulsation felt all over the body, is more or less associated with violent Lachesis headaches.

In the text we find weight and pressure as a strong feature of the Lachesis head symptoms. With almost any complaint of the body, with typhoids, at the menstrual period, during the congestive chill, it seems that the body becomes cold, the extremities become cold, the knees are cold, the feet are cold, and it is impossible to keep them warm, while the face is purple and mottled, the eyes are protruding and engorged, and this awful pain in the head, with a tendency to become unconscious, incoherent speech, difficulty of articulation, and finally actual unconsciousness.

In relation to the head symptoms and mind symptoms and the sensorium in general, the oversensitiveness that is found in Lachesis ought to be mentioned. His symptoms become very intense. The vision becomes very intense; the hearing becomes intense; the sense of touch especially is overwrought. The touch of the clothing becomes very painful, while hard pressure may be agreeable. The scalp becomes so sensitive to the touch of the hand that it is painful, while the pressure from a bandage is agreeable. Oversensitive to noise, oversensitive to motion in the room, to conversation and to others walking over the floor. By these circumstances the pains are increased. The patient becomes extremely sensitive throughout all the senses of the body. 

The oversensitiveness to touch is probably extensively in the skin, because of the fact that hard pressure often gives relief. In one who is suffering from peritonitis, from inflammation of the ovaries or uterus, or any of the abdominal viscera, the skin is so sensitive to the clothing that contrivances are sometimes necessary to relieve the suffering from the touch of the bed clothing.

Something in the form of a hoop will be found in the bed, or the patient will have the knees drawn up, or with the hands will hold the clothing from touching the body. The ordinary weight of the hand may bring out the soreness that is in the abdomen, which is an entirely different soreness, whereas the clothing touching the abdomen only brings out the oversensitiveness of the skin. The mere touch of the skin with the finger or hand is unbearable.

There are many inflammatory and congestive conditions of the eyes. The eye symptoms are worse after sleep, and the eyes are oversensitive to touch and light. With the eye symptoms we have headaches, because the brain and eyes are so closely associated. In the sore throats, when the spatula or tongue depressor happens to touch the wall of the throat, the tonsil, or the root of the tongue, there is a feeling as if the eyes would be pressed out. Violent pain in the eyes from touching the throat. Lachesis is a great jaundice medicine, because it produces much disturbance in the liver. Yellowness of the skin and whites of the eyes, and thickening of tissues about the eyes. "Fistula lachrymalis," which is accompanied by long standing eruptions about the face.

Oversensitiveness of the meatus auditorus externus. Anything introduced into the canal of the ear will cause violent, spasmodic coughing and tickling in the throat. So sensitive is the mucous membrane of the ear that a violent cough, like whooping cough, will come on from touching the mucous membrane of the ear. This only shows the oversensitiveness of reflexes, and the oversensitiveness in general. With the hearing there is the same oversensitiveness that we have spoken of elsewhere. The Eustachian tube becomes closed with a catarrhal thickening, stricture of the Eustachian tube.

The catarrhal symptoms of the nose are prominent. Frequent bleeding of the nose and body, watery discharge from the nose. Always taking cold in the nose. Stuffing up of the nose, with disturbance of smell. Oversensitiveness to smell, and oversensitiveness to odors, finally loss of smell. Lachesis has inflammatory conditions, very chronic in character, with crusty formations in the nose, sneezing, watery discharges from the nose and catarrhal headaches. Sometimes the headache goes off when the catarrhal discharge comes, and when the catarrhal discharge stops the headache comes on. Violent headache with discharge, with sneezing and coryza.

Congestive headaches with coryza. This catarrhal condition has led to the use of Lachesis in syphilis. It is sufficiently similar to cope with the severe forms of nasal syphilis; syphilis where it has affected the nasal mucous membrane, producing- crusts and finally affecting the bones. Foetid ozaena; very offensive discharges from the nose. Bleeding from the nose need not surprise you, because Lachesis is a haemmorrhagic remedy.

The blood from the nose or any part, when it dries or clots, looks like charred straw or becomes black. Parts bleed easily. Copious and prolonged uterine haemorrhage, copious and prolonged menstruation, bleeding from the nose, vomiting of blood, haemorrhage from the bowels in typhoids. "Great sensitiveness of the nostrils and lips, swelling of the lips, great swelling and tumefaction of the nose in old cases of syphilis. The nose swells up and becomes purple. The nasal bones are very sore, soreness upon sides of the nose. Lachesis is an especially useful medicine in old drunkards who have red nose, and in heart affections with red nose. A red knob on the end of the nose, a strawberry nose.

The face is purple and mottled, the eyelids are tumid, very much puffed; not bloated as in oedematous subjects, but puffed. There is not the pitting upon pressure that we find in oedema, although Lachesis has that, but there is a puffiness peculiar to Lachesis, the face looks swollen and inflamed, due to a venous stasis, so that the face is purple and mottled. The nose is tumid, yet it will not remain pitted upon pressure. The lips feel as if inflamed, yet are not inflamed, simply sensitive to pressure.

The face has also an oedematous appearance in which there is pitting upon pressure, in cardiac affections, in cases of Bright's disease. On the other hand the face becomes very pale, pale and cold; the skin covered with scaly eruptions. Eruptions that bleed easily, with crusty eruptions, with vesicular eruptions. Eruptions that fill with blood, bloody vesicles and large blood blisters, such as occur sometimes in burns, with burning. The face becomes jaundiced and very sallow. At times it takes on the appearance also of a chlorosis. If you have once seen the chlorotic color, it need not be described. It is a condition of anaemia, with yellowish pallor, ash colored or grey, intermingled with a sort of greenish color, so that the ancients often referred to it as green sickness. Again the face becomes livid and puffed like the bloated aspect of drunkards, the mottled purple appearance of drunkards who have been drinking for years, until they are bloated and broken down and have a besotted aspect. You see that in Lachesis.

In Lachesis we have a remedy for erysipelas and gangrenous affections, and about the affected part there is the Lachesis appearance, that is the mottled, purplish appearance. Lachesis has become clinically a marked remedy for erysipelas and for gangrene. As provers do not follow up remedies until they produce these things, we have to gather them from the poisonous effects and clinical observation.

In Lachesis there is oozing of blood around the teeth, the gums bleed easily. Dry crusts appear upon the teeth in zymotic diseases, often black formations, sordes, and the tongue takes part in the appearance of the mouth and becomes slick. This occurs in typhoid conditions when there is a total loss of assimilation, the appetite is entirely gone, the stomach will not take food, and when food is put into the stomach it is rejected. There is also paresis of the tongue. The tongue seems to be like leather in the mouth, it is moved with great difficulty. And the speech is like that of one half intoxicated; he is unable to articulate. The tongue swells and is protruded very slowly.

It is dry and catches on the teeth and seems to have lost its stiffness. Seems like a rag, or as if the muscles did not act upon it so that it cannot be protruded, or if it is protruded it trembles and quivers and jerks and catches on the teeth. Again it is swollen, it is denuded of its papillae, and smooth, shiny and glassy as if varnished. In the mouth there is a soapy appearance of the saliva. The saliva runs into the mouth copiously and the patient will often lie with the head over the side of the bed, and the saliva dripping into a pan or commode.

The saliva is stringy and can be pulled out of the mouth in strings; white mucus or saliva. This is not an uncommon feature in diphtheria, in sore throat, in inflammation of the tongue and mouth and gums, and in inflammation of the salivary glands. When this mucus is thick, tough, yellow, stringy and ropy it is like Kali bichromicum. 

You will often find in severe sore throat that the patient will lie and gag, and cough, and attempt with difficulty to protrude the tongue to expel the saliva from the mouth. Very often the pain is so severe in the root of the tongue that he cannot expel the saliva by the tongue and he will lie with the open mouth over a commode, or with a cloth over the pillow, to receive the thick, ropy saliva. In such a state with sore throats, especially those that commence on the left side and go to the right, you hardly need to question longer, for it is the aspect of Lachesis. This state of affairs would lead to Lachesis in ordinary inflammatory conditions of the tongue and in cancerous affections of the tongue. Lach. has in its nature the tendency to formation of malignant scabs and malignant ulcers, such as we find in epithelioma. It has cured a number of cases of epithelioma. It has been a. very useful remedy in lupus. It is an important remedy in syphilitic sore throat, in syphilitic ulceration of the throat, tongue and roof of the mouth with this copious, stringy saliva.

The muscles of the pharynx become paralyzed and will not act, and hence the food will collect in the pharynx, that is, the bolus to be swallowed goes to the pharynx and stops, and then a tremendous effort at swallowing, with gagging and coughing and spasmodic action of the chest, takes place in order to carry on respiration, and he will not again attempt it. This state often occurs with diphtheria. I have a number of times seen it brought about by *the physician, who has, instead of giving just enough Lachesis, high enough and similar enough to the disease to cure, given it as low as he could get it, the 8th or 10th, dissolved it in water and fed it all through the diphtheritic state.

When you come across cases that have been treated in this way you need not be surprised if a post-diphtheritic paralysis comes on, because Lachesis will produce it. It may cure the diphtheria, but it will leave its poisonous effects which will last that patient a lifetime. Every spring the symptoms of Lachesis will crop out. In all the circumstances of aggravation described the symptoms of Lachesis will crop out if he has once been poisoned by it.

In the sore throat we have a combination of symptoms. Lachesis has produced this state; going from left to right; but with the sore throat there is a sensation of fullness in the neck and throat, difficult breathing, pallor or plethoric appearance of the face, choking when going into sleep, the peculiar kind of saliva and aggravation of the throat symptoms from warm drinks. There is not always an aggravation of the pain itself from warm drinks, but the patient is often unable to swallow warm fluids. 

The swallowing of warm fluids often causes choking, and after a swallow of warm tea is taken the patient will clutch at the throat and it seems as if he would suffocate. He says, "Oh! Do not give me any more warm drinks." Something cold will relieve. The dyspnoea and the distress about the throat is increased by swallowing something warm. Now, in the sore throats of Lycopodium, warmth often benefits, but it is also true in some cases of Lycopodium sore throat, they want cold drinks and cold feels good to the throat.

Very often in the more acute symptoms of Lachesis a warm drink in the stomach is hurtful and causes nausea and suffocation and increases the choking and palpitation and the fullness in the head, whereas in the chronic cases of Lachesis, those that have been poisoned years before, there will be a sensation of nausea and tendency to vomit from taking a drink of cold water and then lying down. The nausea comes on after lying down, that is, let the patient take a drink of ice cold water and go to bed and nausea will come on. Such a state is peculiar to Lachesis. It has been a later observation of those who have long before proved Lachesis. The symptoms of Lachesis have sometimes to be taken years after.

Lachesis has ulcers in the throat. It has aphthous patches, it has red and grey ulceration, it has deep ulceration. The tendency to ulceration upon the margins of mucous membranes is peculiar to Lachesis. Also ulceration upon the skin, where the circulation is feeble. It seems that the pain in the throat is particularly marked between the acts of swallowing, and the pressure of the bolus going over the inflamed tonsils relieves the pain. Always choking when swallowing, choking and gagging in the throat. The cough is a choking cough and produces a sensation of tickling.

This is like the Bell. cough. Bell. antidotes a Lach. cough, it has a cough so much like Lach. that no one can tell them apart. Again the throat takes on extreme dryness in Lach., and this dryness is without thirst, dryness with aversion to water. Much inclination to swallow; the tendency is to continuously swallow, yet it is painful. Empty swallowing is more painful than the swallowing of solids. Some Lach. patients suffering from cardiac affections are annoyed with constriction of the throat, choking in the throat when anything warm is swallowed, and sometimes when going into a warm room, choking and palpitation of the heart. Tendency to chronic sore throat or recurrent sore throat and ulceration with every recurring sore throat. Liquids, of course, you will see, are analogous to empty swallowing, and empty swallowing causes more pain than the bolus which presses upon the sore throat, because it is of the nature of a slight touch. The slight touch increases the soreness and pain in the throat.

Slight pressure of the collar increases the pain in the throat. With the sore throat the muscles and glands about the neck become painful, inflamed and swollen, and very tender to the touch. With the sore threat, very commonly, there is pain in the base of the brain or in the back of the head, and soreness of the muscles of the back of the neck, which is often relieved by lying on the back and aggravated by lying on either side. If you look into the throat it has a mottled, purplish appearance. Put all these things together, with the copious flow of tenacious saliva, and you will be able to manage cases of diphtheria that commence on the left side and spread to the right, whether the membrane is scanty or copious. Tonsilitis with suppuration of the tonsils, when the left tonsil becomes inflamed and after a day or two the right one becomes inflamed and swollen, and they both finally go on to suppuration, or when one swells and suppurates and the other swells and supporates. Diphtheritic appearances of the throat, spreading from left to right. The pharynx is full of thick, white, ropy mucus in the morning; must hawk out a mouthful of mucus in the morning.

The abdomen is distended with flatus. The abdomen is tympanitic in typhoid condition, much rumbling in the distended abdomen. The clothing cannot be tolerated, not even the slightest touch of the clothing, and yet it may require hard pressure to bring out soreness that is deep in the abdomen. This state is as it is in inflammation of bowels, ovaries and uterus, the patient lies on the back with the clothing lifted from the abdomen. Violent, labor-like pains, menstrual colic, present in typhoid, in puerperal fever, in malignant scarlet fever, in the more malignant affections or zymotic forms of the continued fever.

Lach. has a series of liver troubles with jaundice; congestion of the liver, inflammation of the liver, enlarged liver and the nutmeg liver. Cutting like a knife in the region of the liver. Vomiting of bile; vomiting of everything taken into the stomach. Extreme nausea; continuous nausea with jaundice. White stool. It has cured cases with gall stone. "Cannot endure any pressure about the hypochondria." In the chronic state the sensitiveness of the skin is so great over the abdomen, and about the waist and hips, that the wearing of the clothing creates pain, great restlessness and uneasiness, the patient grows increasingly nervous and finally goes into hysterics. Sensitiveness over the lower abdomen; can scarcely allow her clothes to touch her.

It seems strange at first reading that Lachesis can be such a common remedy at the menstrual period. It is also laid down as a remedy for the climacteric period. Now if you will study the cases of many women at the climacteric period you will find that many of them have the flushes of heat and the surgings in the head and the great circulatory disturbances that are found under Lachesis. This is also true of the complaints, the headaches, etc., that come in women at the climacteric period and at the menstrual period. The Lachesis symptoms are strong in women during menstruation. There is violent headache, boring pain in the vertex, nausea and vomiting during menses.

The discharge in the female, either as a menstrual flow or as a haemorrhage, is black blood. Pain in the left ovarian region, or going from left to right. Induration of one or both ovaries. It has cured suppuration of the ovaries. The uterine region is very sensitive to touch, to the slightest contact of the clothing; in inflammation of the ovaries, pains in the ovaries and uterus going from left to right. Pains in the pelvis going upwards to the chest, sometimes a surging of pain going upwards, grasping the throat. Labor pains surge up, with clutching at the throat, or the labor pains cease suddenly, with clutching at the throat.

The menstrual pains increase violently until relieved by the flow. The menstrual sufferings are before and after the flow, with amelioration during the flow. The menstrual flow intermits one day and then goes on for one day, and during the intermission there is likely to be pain or headache. Menorrhagia with chills at night and flushes of heat in the daytime.

During the menstrual period violent headache, especially at such times as the flow slackens up. It is a general feature of Lachesis to be relieved by discharges. Catamenia flow but one hour every day; on stopping, violent pains follow in region of left ovary, alternating with gagging and vomiturition.

It is especially useful at the menopause, because of the flushes of heat. Uterine haemorrhage, fainting spells, suffocation in a warm room; orgasm of blood most violent. Complaints during pregnancy. Inflammation of the veins of the leg. Varicose veins, blue or purple, extreme sensitiveness along the veins; sensitive to the slightest touch, though relieved by pressure."

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