: This remedy comes in very nicely after Alumen, which has much Alumina in its nature and depends largely upon Alumina, which is its base, for its way of working.

It occurs to me to throw out a little hint. When you have a good substantial proving of an oxide or a carbonate, and the mental symptoms are well brought out, you can use these, in a measure in a presumptive way, in prescribing another salt, with the same base, which has a few mental symptoms in its proving.

For instance, you have a group of symptoms decidedly relating to Alumen.

The mental symptoms of Alumen, however, have not been brought out to any extent, but still you have the mental symptoms of the base of Alumen, which is the oxide, so that if the patient has the mental symptoms of Alumina and the physical symptoms of Alumen, you can rationally presume that Alumenwill cure because of the Aluminumin each.

: We know the mental symptoms of Alumina fairly well.

It especially takes hold of the intellect and so confuses the intelligence that the patient is unable to effect a decision; the judgment is disturbed.

He is unable to realize; the things that he knows or has known to be real seem to him to be unreal, and he is in doubt as to whether they are so or not.

In the Guiding Symptomsthis is not so plainly expressed, but in the Chronic Diseaseswe have a record of this which is the best expression of it that occurs anywhere.

There we read:

"When he says anything he feels as if another person had said it, and when he sees anything, as if another person had seen it, or as if he could transfer himself into another and only then could see."

That is to say, there is a confusion of mind, a confusion of ideas and thoughts. It has cured these symptoms.

The consciousness of his personal identity is confused. He is not exactly certain who he was; it seemed as though he were not himself.

He is in a dazed condition of mind. He makes mistakes in writing and speaking! uses words not intended; uses wrong words.

Confusion and obscuration of e intellect. Inability to follow up a train of thought. Then he enters into another state, in which he gets into a hurry. Nothing moves fast enough; time seems so slow; everything is delayed; nothing goes right.

Besides this he has impulses. When he sees sharp instruments or blood, impulses rise up within him and he shudders because of these impulses. An instrument that could be used for murder or for killing causes these impulses to arise; impulse to kill herself.

The Alumina patient is very sad, constantly sad. Incessantly moaning; groaning, worrying, fretting and in a hurry.

Wants to get away; wants to get away from this place, hoping that things will be better; full of fears.

All sorts of imaginations. A sort of general apprehensiveness. When he meditates upon this state of mind he thinks he is going to lose his reason.

He thinks about this frenzy and hurry and confusion of mind, how he hardly knows his own name, and how fretful he is, and he wonders if he is not going crazy, and finally he really thinks he is going crazy.

Most of the mental symptoms come on in the morning on waking. Sadness and weeping on waking in the morning. His moods alternate.

Sometimes his mental state is a little improved and his mood changes into a quiet placid state, and again he goes into fear and apprehensiveness. Some evil is going to take place and he is full of anxiety. Anxiety about the future.

: The next most striking feature is the way in which the remedy acts upon the nerves that proceed from the spine.

There is a state of weakness of the muscles supplied by these nerves; weakness over the whole body. There is difficulty in swallowing, a paralytic condition of the oesophagus; difficulty in raising or moving the arms; paralysis of one side of the body, or paralysis of the muscles of the lower extremities, or of the bladder and rectum.

The paralytic state begins as a sort of a semi - paralysis, for a long time merely an inactivity, which grows at length into a complete paralytic condition. Everything is slowed down.

The conductivity of the nerves is impaired so that a prick of a pin upon the extremities is not felt until a second or so afterwards. All of his senses are impaired in this way until it really means a benumbing of the consciousness and appears to be a kind of stupefaction of his intellect, a mental sluggishness. Impressions reach his mind with a marked degree of slowness.

The paralytic state runs through the remedy and is observed in various parts in many ways. The bladder manifests it in the slowness with which the urine passes.

A woman sits a long time before the flow starts, with inability to press, and then the stream flows slowly. The patient will say she cannot burry the flow of urine. The urine is slow to start and slow to flow, and sometimes only dribbles. At times it is retained and dribbles involuntarily.

This slowness is observed also in the rectum. Its tone is lost and there is inability to perform the ordinary straining when sitting at stool, and so paretic is the rectum that it may be full and distended, and the quantity of faeces enormous, and yet, though the stool is soft, there is constipation.

In this remedy there is often a hard stool, but we notice that the remedy will do the best work where there is this paretic condition of the rectum with soft stool. If the mental symptoms however, are present, such as I have described, with large, hard and knotty or lumpy stool, Alumina will cure.

Now, so great is the straining to pass a soft stool that you will sometimes hear a patient describe the state as follows:

When sitting upon the seat she must wait a long time, though there is fullness and she has gone many days without stool; she has the consciousness that, she should pass a stool and is conscious of the fullness in the rectum, yet she will sit a long time and finally will undertake to help herself by pressing down violently with the abdominal muscles, straining vigorously, yet conscious that very little effort is made by the rectum itself.

She will continue to strain, covered with copious sweat, hanging on to the seat, if there be any place to hang on to, and will pull and work as if in labor, and at last is able to expel a soft stool, yet with the sensation that more stool remains.

Of course a number of other remedies have this straining to pass a soft stool, but they have their own characteristics. Take for example an individual who cannot keep awake; she says that it is impossible for her to read a line without going to sleep; that she can sleep all the time; she suffers night and day from a dry mouth, and the tongue cleave to the roof of the mouth.

Now let her describe this state of straining and struggling to expel a soft stool, and you hardly need to go any further before you know the remedy.

If that patient in addition to what she has said tells you that she is in the habit of fainting when standing any length of time, that she is disturbed in a close room and has all sorts of complaints in the cold air, it is Nux moschata.

Now you see how easy it is for remedies to talk; they tell their own story. Suppose a woman should come to you who has been suffering from haemorrhage, from prolonged oozing, who is pallid and weak and is distended with flatulence, with much belching and passing of gas, and the more she passes the worse she feels, and she has these same symptoms of straining a long time to pass a soft stool, tremendous effort with inactivity of the rectum. You could do nothing but give her China.

Now you know how easy it is for remedies to talk and tell their own story.

By allowing remedies to talk and tell their own story, individualization is accomplished.

I have said all that to show that it is not upon the inactivity of the rectum that you are to decide upon the remedy.

Individualization must be made through the patient. That is a principle that should never be violated. You may have twenty remedies all possessing a certain symptom but if you have a few real decided things that you can say about the patient, the manner in which he does business, the manner in which the disease affects the entire man, then you have something to individualize by.

You have seen the Alumina patient, the China patient and the Nuxmoschata patient. The sole duty of the physician is to treat the sick, which means to study the patient himself until an idea of the sickness is obtained.

: This medicine is full of vertigo; he quivers, reels and "objects go round" almost constantly. It corresponds to the vertigo of tired-out people, old broken down patients, men worn out from old age.

Vertigo also that comes on when closing the eyes, as is found in spinal affections, in sclerosis of posterior lateral columns.

Alumina has produced affections analogous to locomotor ataxia. It produces numbness of the soles of the feet, the fulgurating pains, the vertigo when closing the eyes, and produces staggering and disturbances of coordination.

It is true that in an early stage of locomotor ataxia Alumina will check the disease process by bringing into order the internal state of the economy.

With Aluminum metallicum I have, stopped fulgurating pains in old incurable cases, and improved the reflexes wonderfully, thus showing the general improvement of the patient.

: Most of the symptoms are < on rising in the morning.

In the morning as I have mentioned it, the urine is slower to pass than after, he has moved about and warmed up a little. His limbs are stiffer in the morning and in the morning he has to whip up his mental state. He wakes up confused and wonders where he is.

You will see that in children especially-they wake up in the morning in a bewildered state, such as you will find in Alumina, Aesculus, Lycopod.

He has to put his mind on things to ascertain whether they be so or not, as to how things should look and wonders whether he is at home or in some other place.

There are many headaches with nausea and vomiting. The headaches come whenever he takes cold. This probably is due to the catarrhal state.

: The Alumina patient suffers almost constantly from dryness of mucous membranes, the nose is dry, stuffed up, especially in one side, commonly the left.

Nose feels full of sticks, dry membranes or crusts, old atrophic catarrh crusts in the posterior nares and in the fossa of Rosenmuller.

Large green, offensive crusts all through the nose. Now comes the relation to the headache. Every time he catches cold the thick yellow discharge slacks up and gives way to a watery discharge and be has pain in the forehead over the eyes, going through the head, with nausea and vomiting.

So when it says headache from chronic catarrh that is what it means. The headache > lying down. He has sick headaches and periodical headaches.

You will see that Alumina corresponds to a constitution that may be called psoric-old, broken-down, feeble constitutions, scrofulous constitutions, such as are inclined to tubercles and catarrhal affections.

The catarrhal tendency of this remedy is marked. Catarrhs are found wherever mucous membranes exist. Alumina affects the skin and mucous membrane extensively, i. e., the external and internal skin, the surfaces of the body.

The patient is always expectorating, he blows the nose much and has discharges from the eyes. There is much disturbance of vision belonging to this catarrhal state that may be spoken of now.

Dimness of vision, as if looking through a fog sometimes described as through a veil. A misty dimness of vision.

There is also disturbance of the muscles of the eye, of the muscles of the ball and of the ciliary muscle. Weak and changeable vision. The paralytic weakness, such as belongs to the whole remedy, will be found in certain muscles, or sets of muscles, so that it is with great difficulty that glasses can be adjusted. The activity of the eye muscles is disturbed.

: The catarrhal state extends over into the back of the nose and the posterior nares are filled up with tough mucus and crusts, and on looking into the throat you will see that the soft palate and the mucous membrane of the tonsils and pharynx and all parts that can be seen are in a state of granulation, are swollen, congested and inflamed.

The pharynx feels dry and there is a chronic sensitiveness and soreness. When swallowing food there is stinging and sensation as if the throat were full of little sticks, especially after a moment's rest, better by moistening and swallowing. In the night air, after keeping still a while, there in an accumulation of ropy mucus.

This extends into the larynx with soreness in the larynx and chest and chronic dry, backing cough. The same catarrhal state proceeds down into the oesophagus, so that it becomes sensitive and clumsy. He swallows with difficulty.

The bolus goes down with an effort and he feels it all the way down. There is soreness and clumsiness, paresis and difficulty of swallowing.

This paralytic weakness reminds the patient that he must put on a little force in order to swallow and this swallowing is felt while the substance goes down as if the oesophagus was sensitive. It has a catarrhal state of the stomach, bowels and rectum so that with the soft and difficult stool there is often an accumulation of mucus.

There is also a catarrhal condition in the bladder, kidneys and urethra and an old gonorrhoea will be prolonged into a catarrhal or gleety discharge.

Sometimes it is not a gleet, but the discharge remains for many months and instead of its being a light milky white, such as is natural in most prolonged cases of gonorrhoea, it remains yellow and is painless. So it is with the vagina.

The mucous discharge from the vagina is thick yellowish-white discharge, sometimes excoriating. Thus we see, in the constitution we have described, that an extensive catarrhal state belongs to the remedy.

: When we come to the skin we find that it takes on a similar state of affairs. The patient is subject to all sorts of eruptions. The skin withers, becomes dry and is subject to eruptions, thickening, indurations, ulcerations, cracking and bleeding.

The eruptions itch worse in the warmth of the bed. The skin itches, even when there is no eruption, when becoming warm in bed, so that he scratches until the skin bleeds. This presents an idea as to eruptions that you will have to consider. A patient comes to you covered with crusts, and he says:

"When I get warm at night I have to scratch, and I scratch until the skin bleeds."

Now in Alumina it is very important to find out whether these crusts were produced by the scratching or whether the eruption, came out as an itching eruption, for in Alumina in the beginning there is no eruption, but he scratches until the skin is off and then come the crusts.

You must here prescribe not for the eruption, but for the itching of the skin without eruption. Now in Mezereum, Arsenicum, Dolichos and Alumina the skin itches and he scratches until it bleeds, and then he gets relief.

Of course after this there is an apparent eruption because crusts form. As soon as the healing begins the itching begins, and he is only relieved when the skin is raw. With the bleeding moisture of the skin there is relief of the itching.

Now some of the books do not make the distinction between itching without eruption and itching with eruption, and hence mostly all young, doctors get to thinking that itching of the skin must always be associated with eruption, and make a mistake in figuring out what kind of an eruption it is.

The skin thickens and indurates and ulcerates, and there are indurations under the ulcers. There is a very sluggish condition of both mucous membrane and skin with a tendency to induration.

Thickening of the mucous membrane will be found anywhere; after the thickening come little ulcerations, and in the course of time indurations are formed at the base of the ulcers. The same thing is true of the skin. Dryness and burning through everything and may be said of all the mucous membranes and the skin in general.

Chronic granular lids. It we turn the eyelids down we will see that the mucous membrane is thickened. Sometimes this thickening or hypertrophy causes a turning out of the lids like ectropion.

"The eyelashes fall out;" that is in keeping with the general state.

The hairs all over the body fall out. Parts become entirely denuded of hair; the hair of the scalp falls out extensively. All sorts of sounds in the ears, buzzing, etc., and derangement of hearing; purulent otorrhoea.

"Point of nose cracked" is in keeping with the remedy.

Induration here and there so that it favors lupus and epithelioma in one who is subject to these swellings and eruptions.

Alumina and Alumen, like Ars., Lach., Sulph. and, Conium, are medicines that relate to these troubles. Some of these have made brilliant cures where there is infiltration.

Upon the skin of the face and other parts of the body there is crawling Itching especially when getting warm. Sensation of tension. Peculiar sensation about the face and other parts not covered by clothing, a sensation of dried white of egg on the face, of dried blood or cobweb on the face.

If you have ever been going through a place where there are cobwebs and a little cobweb has strung across your face you will know what a peculiar sensation of crawling it produces, and you cannot leave it alone until it is removed.

That sensation particularly belongs to Alumina, Borax, Bar. c.

Little, crawlings and creepings in the skin. Itching of the face. These symptoms are so irritating that the patient will sit and rub his face all the time.

You will think that he is nervous. He has the appearance of being nervous as he sits rubbing the back of his hands. It is well to find out whether he does this because he cannot keep his hands still or because of the itching. Because of this itching sensation in the face he carries the hand to the face as though to brush away something.

: Perhaps I have not said as much as should be said about the throat.

"Ulcers in the fauces, spongy, secreting a yellowish brown, badly smelling pus."

It may be said that the patient is often a victim of chronic sore throat. There is this about Alumina, it has a special tendency to localize itself upon mucous membranes.

You will find in an Alumina subject bleeding from all mucous membranes. He has catarrh of the nose and red eyes, and his nose becomes stuffed up and he has many acute colds; very severe throat trouble.

Discharges from all of the orifices. It is not a medicine that would be selected for a cold settling in the throat, not a remedy for acute sore throat, but it is a deep acting anti psoric, and act for months.

Its greatest usefulness is as a remedy for taking cold.

In this respect it is like Sil., Graph. and Sulfur. It effects tissue changes, and it does this slowly, for it is a slow-acting medicine.

While the patient himself with these deep seated psoric affections feels better generally after the remedy, it will be months before his symptoms go away.

He may say: "I feel better, but my symptoms all appear to be here. I can eat better and sleep better."

Then it would be unwise to change the remedy. You need not expect to get immediate relief of the catarrhs and pains in the back and other symptoms for which you gave this remedy.

You may be satisfied if you get the results after many weeks. You will find the same thing in the paralytic weakness produced by Plumbum.

There is a new drug that is coming into use, the proving of which is very full and rich, and it is analogous to the symptoms of this remedy. It is Curare.

: I wish we had a finer proving of it, but it is rich with a great many things similar to Alumina and Plumbum, and especially in the weakness of the hands and fingers of pianists.

An old player will say that after she has been playing-for some time her fingers slow down. The weakness seems to be in the extensors. Lack of ability to life the fingers; the lifting motion is lost.

Curare to a great extent overcomes that, causes quickness to that lifting power of the fingers. But this remedy also runs through in general way such paretic conditions; while Curare is especially related to a paralytic condition of the extensors more than the flexors, the paralysis in Alumina is of both flexors and extensors.

: This medicine is one of the few that have been found to be aggravated from starch, especially the starch of potatoes.

Aggravation from eating potatoes. It has indigestion, diarrhea, great flatulence, aggravation of the cough from eating potatoes.

It has also aggravation from salt, wine, vinegar, pepper and from spirituous drinks.

Alumina is a spinal remedy and aggravation from spirituous drinks is in keeping with some other spinal remedies.

You find it in Zincum. The Zincum patient cannot drink wine, for all of his complaints are aggravated by it.

This medicine is so sensitive and so easily overcome by a small amount of liquor that he is obliged to abandon it. He is not only intoxicated by it, but it aggravates his complaints.

: Now the digestion has practically given out in this medicine. He is subject to catarrh of the stomach, to ulceration of the stomach, to indigestion from the simplest food. Sour and bitter eructations.

Vomiting of food, mucus or bile. Nausea, vertigo, heartburn, much flatulence. Vomits mucus and water. Stomach is distended with gas. The liver is full. of suffering. Both hypochondria are full of misery, but especially the right.

When going over Alumen I called attention especially to its antidotal relation to Lead.

This remedy also will overcome the poisonous effects of lead and sensitiveness to lead. Colic and paralytic weakness in lead workers, painters and artists and in those who are so sensitive to lead that from using hair wash containing lead they are paralyzed.

Not many years ago the acetate of lead was commonly used by women for leucorrhoea, but it was found that so many were sensitive to it that it was abandoned, Alumina is the most prominent antidote to the affections which have come about through that sensitive state.

: There is so much under stool and rectum that belongs to the general state that there is scarcely anything left to be presented except some important particulars. As you might suppose, this remedy has fissures; you would naturally expect these when you consider what kind. of mucous membranes and tissues this patient manufactures. He suffers greatly from constipation, he does much straining, the mucous membrane is thickened and swollen, and hence we have a fissure.

When you see a remedy manufacturing and producing such a state upon the economy, growing that kind of mucous membrane that would favour fissures, you do not have to wait until you have cured a fissure with that remedy to find out if it will suit the case.

You do not have to resort to the repertory to see what this remedy has done in fissure. From your general knowledge of the medicine, you will see that it ought to cure the patient, as it produces such a condition of the mucus membrane and skin as would be naturally found in one who has a fissure.

The skin indurates and ulcerates and becomes clumsy and unhealthy and constipation is produced, and so, after studying the remedy in that way, you are not surprised if it cures a fissure.

You can also think over what other medicines have this state of the economy and see what other remedies you would expect to cure a fissure with.

If you look into the nature of Nitric acid, Causticum and Graphites, you will see why they have had a wonderful record for curing fissure. That is the way to study your Materia Medica; see what it does to the man himself, to his organs and tissues.

: "Frequent micturition."

"Urine voided while straining at stool, or cannot pass urine without such straining"

That is a high grade symptom, it is a peculiar symptom, and may be called a particular of first grade. He must strain at stool in order to empty the contents of the bladder.

"Urine smarting, corroding."

"Feeling of weakness in the bladder and genitals."

"Swelling and discharge of light yellow pus from urethra."

"Burning with discharge of urine.''

: The symptoms of the male sexual organs are characterized by weakness, impotency and nightly emissions; suitable when the sexual organs are worn out from abuse or over use.

There is fullness and enlargement of the prostate gland and various disturbances of the prostrate, with sensation of fullness in the perineum.

Unpleasant sensations and distress in the region of the prostate gland after coition. Complaints at the time of, or after ejaculation, or after an emission.

The sexual desire is diminished and sometimes entirely lost. Paralytic weakness or paresis of the sexual organs; a state that is in keeping with the whole remedy.

"Discharge of prostatic fluid during difficult stool."

"Painful erections at night."

: The female has a great deal of trouble that can be cured with this remedy, but her troubles are mostly catarrhal.

An instance of this is the leucorrhoea; copious, acrid or excoriating, yellow leucorrhoea; leucorrhoea so copious that it runs down the thighs, making the parts red and inflamed.

Ulceration about the os. The mucous membranes are weak and patulous and ulcerate easily. All the parts are in a state of weakness.

There is dragging down from the relaxed condition of the ligaments. Sensation of weight; the pelvic viscera feel heavy. The discharge, stringy, looking like white of egg, copious and acrid; transparent mucus.

" Leucorrhoea, corroding, profuse; running down to heels."

It is more noticeable in the day time, because these complaints are generally worse when walking or when standing, which is not really an important symptom, but a common condition.

After menstruation it takes the woman nearly until the next period to get straightened up. All her muscles are weak; there seems to be no tonicity about her. It is highly suitable to women drawing near the end of menstruation, about forty years of age; the menstrual period prostrates, the flow is scanty, yet prostrating; the sufferings are terrible and the patient is miserable at the menstrual period. After menses, exhausted in body and mind, is a strong feature of Alumina.

It is a suitable remedy again when the woman has a gonorrhoea which has been prolonged by palliation. She has been made comfortable by partly suitable remedies, but it seems that no remedy has been quite deep enough to root out the trouble, for it keeps coming back.

In a discharge that keeps returning, better for little while on Pulsatilla, and on this and that and the other thing, and even on Thuja, given more especially because it is gonorrhoea than because she is a sick woman.

The patient is tired and worn out, and when you come to look at the whole patient and you see the paretic condition, the continued return of the discharge that has been palliated by remedies, think of this medicine in both the male and female.

The discharge is a painless one in the male. The gonorrhoeal discharge has lasted a long time, going and coming, until now there is left but a few drops and it is painless.

The remedy has cured many of these old cases. Threatening chronic catarrh. The mucous membrane everywhere is in a congested state and is weak.

A pregnant woman has some trouble as well. A woman, who is not naturally a sufferer from constipation, when pregnant becomes constipated, with all the characterizing features of Alumina, i. e., the inactivity of the rectum, no expulsive force; she must use the abdominal muscles, must strain a long time.

: Again, the infant has a similar kind of straining. You will see the new-born infant, or the infant on few months old, that will need Alumina.

It is a very common medicine for constipation in infants when you can find nothing else; the child will strain and strain and make every effort to press the stool out, and upon examining the stool it is found to be soft, and should have been expelled easily.

It has hoarseness and loss of voice and paralytic weakness of the larynx. That is not strange; it is only in keeping with the general state, the broken down constitution. He has a weak voice and, if a singer, he is capable of singing only a little while, only capable of slight exertion.

Everything is a burden. A paralytic condition of the vocal cords, which steadily increases to loss of voice.

: The most striking things we come to now are the cough and chest troubles. There is expectoration in some of the coughs, but the cough is usually a constant, dry, hacking cough one of those troublesome lingering coughs that has existed for years.

It competes with Arg. met.in its character of the dry, hacking cough, especially associated with weakness, but Arg. met. has the cough in the day time, which is not so in Alumina.

The Alumina cough is in the morning. Here is a symptom that about covers the Alumina cough:

"Cough soon after waking in the morning."

Every morning, a long attack of dry cough. The cough is hard, a continued dry hacking, and she coughs until she loses her breath and vomits, and loses the urine.

This symptom commonly occurs in the woman.

"Dry, hacking cough with frequent sneezing."

It says in the text "from elongated uvula," but it should read "from sensation of elongated uvula."

It is a sensation as if there were something tickling the throat; a tickling as if the uvula were hanging down a long distance, and he will tell you that his palate must be too long.

Another expression which is the same thing is "cough from sensation as of loose skin hanging in throat."

Some times those who do not know about the palate will talk of something loose in the throat, while those who know they have an uvula will generally call it the palate. But it is the same idea. Tickling in the larynx, too.

: This is always quoted in singers. We would think of Alumina when singers break down in the voice from paralysis or from overwork of the voice.

The voice lets down and becomes feeble, and, when taking cold, there starts up a peculiar kind of tickling.

Alumina is very useful in these cases. Arg. met. was the remedy used by the earlier homoeopaths for singers and talkers with much trembling and letting down of the voice before the value of Alumina was known in such conditions.

Let me tell you something here about Rhus, as I may not think of it again. Many old singers, after taking cold, have a weakness left in the voice, which they notice on beginning to sing.

On beginning to sing the voice is weak and husky, but after using it a little while it improves. Give Rhusto all these patients, prima donnas, lawyers, preachers, etc.

They must warm up the voice and then they are all right, but they say:

"If I go back into the green room and wait a little while, when I commence to sing again I am worse than ever."

The voice is better if they stay in a very hot room and keep it in use. This fits into the general state of Rhus.

: There is a kind of hoarseness that you may discover to be a little different from the paralytic hoarseness of Alumina and Arg. met.

This hoarseness of which I speak belongs to this same class of people; on first beginning to use the voice it seems that they must get rid of some mucus by clearing the throat until the voice can get to work.

The vocal cords on beginning to work are covered with mucus and on getting rid of it they can do very good work, so long as they keep at it.

That is Phosphorus. In such cases the use of the voice becomes painful. The vocal cords are painful after motion and the larynx is painful to touch.

Some times this is so marked that it is like stabbing with a knife on trying to use the voice. So we must individualize hoarseness very extensively.

Homoeopathy is a matter of discrimination. Soreness of the chest which is much increased by talking. There is weakness of the muscular power of the chest. The lungs seem weak and the chest has a sensation of weakness in it. Jar increases the misery of the chest.

: The next most striking features will be in connection with the back and limbs, and I have spoken of these in general way.

Burning in the spine; much pain in the back. Burning and stitching pains in the back. He expresses it as follows:

"Pain in the back, as if a hot iron was thrust through lower vertebrae."

In myelitis this medicine does wonderful work when there is a considerable amount of spasmodic condition of the back as well, showing that the membranes are involved.

Another thing that belongs to this remedy that is a well known state in myelitis is the hoop sensation; sensation of bandages here and there about the limbs and body is a common symptom.

A sensation of a tight cord around the body characteristic of the most marked state of irritation and myelitis. Irritation of the spinal cord with sensitive places.

Burning places as if a hot iron were forced into the spine. Pain along the cord, rending, tearing pains in the cord with paralytic weakness, increasing paralysis and complete paralysis; paralysis of one side of the body.

"Pain in sole of foot on stepping, as though it were too soft and swollen."

"Numbness of heel when stepping."

"Trembling of knees," this is a mere matter of the general weakness.

"Limbs go to sleep when sitting."

Whenever the limb is pressed again anything it will go to sleep. Feeble circulation, feeble conductivity, feeble nerve action; everything is slowed down.

Arms and legs feel heavy.

"Pains in limbs as if bones were squeezed narrower, with pressure in the joints."

Now I will read some of the nerve symptoms which will corroborate some of the things we have gone over.

"Want of bodily irritability."

"Great exhaustion of strength, especially after walking in open air."

"One-sided paralysis, especially of the extensors."

"Rheumatic and traumatic paralysis in gouty patients."

Gouty patients with nodules in the joints; old broken down constitutions with paretic exhaustion.

"Excited condition of mind and body."

Tremblings here and there in the body.

"Slow, tottering gait as after severe illness."

He must make slow motions, he cannot hurry.

"Involuntary motions."

: There are all sorts of dreams and disturbances in sleep, so that the sleep may be quite disturbed and restless.

Unrefreshing sleep, waking up with palpitation of the heart.

"Many dreams and frequent awaking; starts in affright; muttering or crying."

"During sleep cervical muscles drew head backward;"

this is in cases of paralytic weakness; has to wake up as the muscles of the back of the neck pull so. Jerks in the back of the neck during sleep.

Running through the remedy very often, there is a great lack of animal heat, coldness, and yet the patient wants to be in the open air; must be well clothed open and kept warm, but wants to be in the open air.

The patient takes cold continually from every change and draft. Sometimes the patient will go to bed as cold as a frog, and when warm in bed is so disturbed by itching and the warmth of the bed that there is no comfort.

These are two extremes coming together. The circulation is so feeble over the extremities and backs of the hands that in cold weather the hands are constantly cold and covered with cracks and fissures that bleed.

: The skin along the shin bone is rough, ragged and itching. It has been said that dry weather and dry, cold weather increase the complaints of Alumina, and that wet weather sometimes ameliorates.

The febrile condition of this remedy is not at all marked. There is not much chill and not much fever, but the passive, slow, sluggish, chronic elements and chronic symptoms are the ones that prevail most markedly. In weak, broken-down cases there are some night sweats and sweating towards morning. Slight chill in morning. Chill with thirst.

A striking feature of the remedy is the chronic dryness of the skin. Sweat is rare and scant.

This is not especially suitable for this copious, exhaustive sweats. It is the very opposite of Calcarea, which sweats copiously, but this remedy, with spinal and paralytic affections, is tired out from exertion, very exhausted, but does not sweat.

Pile on the covers to make him sweat if you will, but he only gets hot and itching and does not sweat.

Scanty sweat. Entire inability to sweat. Chronic dryness of skin with fissures. The skin becomes worn and ragged and fissured from its dryness. Great dryness of the thick skin over the back of the hands, and in cold weather the hands become cold and discolored.