Cinchona Boliviana cinch-b.

Adapted to stout, "swarthy" persons; to systems once robust which have become debilitated, "broken down," from exhausting discharges.

Apathetic, indifferent, taciturn (Phos. ac.); despondent, gloomy, has no desire to live, but lacks courage to commit suicide.

Ailments: from loss of vital fluids, especially hemor- rhages, excessive lactation, diarrhœa, suppuration (Chin. s.); of malarial origin, with marked periodicity; return every other day.

After climacteric with profuse hemorrhage; acute diseases often result in dropsy.

Pains: are darting or drawing-tearing; in every joint, all the bones, periosteum as if strained, sore all over; obliged to move limbs frequently as motion gives relief (Eup., Rhus); renewed by contact, and then gradually increase to a great height; < slightest touch, > by hard pressure.

Great debility, trembling, aversion to exercise; nervous; sensitive to touch, to pain, to drafts of air; unrefreshing sleep < after 3 A. M.

One hand icy cold, the other warm (Dig., Ipec., Puls.).

Headache: as if the skull would burst; intense throbbing of head and carotids, face flushed; from occiput over whole head; < sitting or lying, must stand or walk; after hemorrhage or sexual excesses.

Face pale, hippocratic; eyes sunken and surrounded by blue margins; pale, sickly expression as after excesses; toothache while nursing the child.

Excessive flatulence of stomach and bowels; belching gives no relief (Lyc., Pod.—gives relief, Carbo v.); < after eating fruit.

Colic: at a certain hour each day; periodical, from gallstone (Card. m.); < nights, after eating; > bending double.

Labor-pains cease from hemorrhage; cannot bear to be touched, not even her hands.

Hemorrhages: from mouth, nose, uterus or bowels; long continued; longing for sour things; blood dark, or dark and clotted, with ringing in the ears, fainting, loss of sight, gen- eral coldness and sometimes convulsions (Fer., Phos.).

Complementary: Ferrum.

From slightest touch; every other day; draft of air; milk; at night; after the chills; mental emotion.

Warmth; during rest; pressure; bending double

Variable. Tertian or double tertian; quotidian or double quotidian; double quartan; malarial; remittent.

Anticipates from two to three hours each attack (Quinine).

"Paroxysm every seventh day, anticipating about three hours each succeeding chill"—W. J. HAWKES.

Not characteristic; may begin at any hour of day; gen- erally toward midday; never at night. 5 P. M., 5 A. M. Parox- ysms return every seven or every fourteen days (Ars., Puls.).

Paludal fevers have always been considered its special domain. A change of theory may revolutionize the cause to which Cinchona is now supposed to be especially adapted; but thanks to similia it will not in the least affect its homœopathic indications.

Great thirst (Caps., Eup., Puls.—thirst and bone pains, Eup.); canine hunger; nausea; anguish; headache; debility; palpitation of the heart, with anxiety; sneezing when exposed to cold air; oppressive colic; and a general feeling of ill- ness.

"Restless sleep night before the paroxysm."—HAHNEMANN.

Without thirst\* (with thirst, Caps., Ign., Quin.).

Thirst ceases as soon as chill begins. General shaking chill over whole body, beginning in the legs below the knees, increased by drinking. Shivering or chilliness, with goose-flesh, after every swallow of drink (abstains from drinking because every swallow

\ Observation by Hahnemann.—In all my observations I have found that the Cinchona fever is characterized by the thirst not appearing during the cold stage, either shuddering or chilliness; that, on the contrary, thirst came after the cold stage, or, which is the same thing, that thirst came shortly before the hot stage set in. increases the chill, Eup. perf.—because drinking causes vomiting, Ars.—shuddering and chill after every drink, Caps.—drinking makes headache and all symptoms unbearable, Cimex). Thirst before or after, but not during the chill. Coldness and shivering when walking in the open air at 5 P. M., disappearing in the room; an hour afterwards, great heat, especially in the face, increased on motion and on walking (Bry.); thirst follows an hour after the disappearance of the heat. Wants to be near the stove, but it increases the chill (Ipec.—relieved by heat of stove, Ign.—relieved by external heat, Ars.). Internal and violent chill, with icy cold hands and feet, and congestion of blood to the head. Chill with pain in the liver. Shaking chill and internal coldness for several hours; shivering over the whole body without thirst; coldness of the hands and feet even in a warm room; chill alternating with heat, skin cold and blue (Camph., Carbo v.—hands cold. nails blue, Nux). Sensation of internal coldness in upper abdomen, after every swallow of drink, and renewed on every inspiration. Coldness over whole body as if dashed with cold water* (Ant. t., Rhus). Paleness and icy coldness of the hands and feet, aggravated by walking; vertigo and paleness of the face.

With thirst (no thirst in regular chill). Febrile chill over the whole body from time to time during the day, especially upon forehead, which has cold sweat upon it; violent thirst a quarter of an hour after the first chill. (No thirst during chill or heat—which is long-lasting—in first paroxysm.) Cold hands in the evening, with hot cheeks; one hand is icy cold, the other warm; ice-cold feet, with warmth of rest of body. (This alternate heat of one part and coldness of another at same time belongs only to this paroxysm.)

Without thirst.\ General heat, with distended veins, congested headache, desire to uncover, but chilly when uncovered (chilly when uncovered in any stage of paroxysm, Nux). Canine hunger or aversion to food, pain in the region of the liver, back, chest, limbs; dryness of mouth and dry, burning lips, with redness of face and often delirium. Long-lasting heat, with sleep. Cough dry, spasmodic, fatiguing, with pain in both hypochondria and at pit of stomach (with stitching pain in chest, Bry.). Heat of the whole body, externally and internally, with swollen veins of the arms and hands*, without sweat or thirst. Heat of the whole body. aggravated by walking (relieved by walking, Caps.). Sensation of heat in abdomen as of hot water running down. The

\ Observation by Hahnemann.—There is likewise no thirst in the Cinchona fever during the hot stage, except some burning of the lips, or some dryness of the parts, which dryness accounts for the symptom; sensation of slight thirst during the hot stage; "the thirst accompanying flushes of heat." In the Cinchona fever thirst sets in after the hot, or, which is the same thing, during the sweating stage. cheeks are red and hot to the patient, although they are not warm.

If he eats in this stage, sleepy after eating. On the least movement an unpleasant sensation of heat in the head and stomach.*

"Entire absence of thirst during height of paroxysm." —**Ad.

Lippe.**

With thirst (no thirst in previous heat). Heat over the whole body, with fine, needle-like stitches in the skin, espe- cially of the throat, together with great thirst for cold water.

Heat alternating with the chill; some thirst for cold water with the chill; heat follows half an hour or an hour after the chill. A very transient sensation of heat over the whole body, with thirst for cold water. Sensation of flushes of heat, with thirst for cold drinks. Warmth and redness of the face, while the rest of the body was cold. The right hand is warm, the left cold; the hands are now warm, now cold; heat, with burning lips and thirst, fol- lowed by sweat; chill, with thirst; then heat, with thirst; the thirst continues even during the apyrexia. Violent desire for cold drinks, accompanied with stinging in various parts of the skin.

"The fever heat, accompanied with stinging over the whole body, seems to form an exception."—HAHNEMANN.

The symptoms occurring before the chill and during the sweat and apyrexia are alike in both paroxysms. The thirst during the chill, with alternate warmth and coldness of different parts at same time; the thirst during heat, with stinging or fine, needle- like stitches in skin, with heat of one part and coldness of another, are the characteristics of this paroxysm.

With great thirst. The first indication of its ap- proach is the return of the thirst which preceded the chill, but which was absent during the cold and hot stages. Intense thirst during chill and especially during heat, positively contra-indicates

Cinchona.

Sweating during sleep. On being covered he sweats profusely all over; this he cannot avoid, although very trouble- some, he is so sleepy he cannot get up. Partial; cold; greasy, or as if mixed with oil; profuse and debilitating (profuse, but not de- bilitating, Samb.); sweat on the back or side on which he lies (sweat on the side not lain upon, Benz.). Profuse sweat over the whole body when walking in the open air (Bry.). Easily excited sweat during sleep and motion (excited by motion only, Bry.— relieved by motion, Caps.). The sweat parboils the skin (Canch. —parboils the fingers, Ant. c.). Often slow in becoming estab- lished, and frequently out of all proportion to the intensity of the cold and hot stages (see Eup.).

"The patient sweats profusely, especially on the back and neck, when he sleeps." —Hahnemann.

White or yellow; thick, dirty coating. Taste: too acute. Bitter taste in the mouth. Indifference to all food, even when thinking of it. Toothache, especially when infant nurses

(Sil.).

Quick, hard and irregular during chill and heat; slow, feeble in apyrexia, sometimes intermittent; more quiet after eat- ing; great swelling of the veins.

Sweats easily; great debility and exhausting night- sweats continue, followed by ringing in the ears, and constricting sensation over vertex from ear to ear. A saffron yellowishness of the skin of scalp, face, neck, chest and abdomen (Chel.); with the characteristic anæmic and cachectic appearance, once seen, never forgotten. There is swelling of both hypochondria, which are painful to pressure and worse by motion, bending, or coughing.

Swelling, pain and pressure of epigastric region, with hyper- trophy of spleen Entire loss of appetite, with sinking feeling in stomach, or hunger easily satisfied. Bitter eructations and bitter vomiting (sour eructations and sour vomiting, Lyc.). The urine is scanty and turbid, with a yellow or brick-dust sediment; and general dropsical symptoms are often present. Bloated or tym- panitic abdomen, and hard spleen or liver in nursing children, with profuse sweating and great weakness (without profuse sweating, Ars.).

This constitutes the paroxysm of Cinchona. But Cinchona has also another, an exception to the rule (probably a secondary re- action) which is often confounded with Arsenicum; hence its notice in this place. It has only two different stages—Chill and

Heat.

The paroxysm anticipates from two to three hours each attack (Chin. s.); returns every seven or fourteen days; never at night; sweats profusely all over on being covered, or during sleep.

The thirst of Cinchona is guiding.

Prodrome; with thirst, intense, long before the chill (Caps.,

Eup.).

Chill; no thirst, or it disappears as chill increases.

Heat; no thirst, as chill passes into fever thirst begins; as fever increases thirst decreases, when fever declines the thirst begins.

Sweat; with great thirst. No thirst during the nervous tension of chill and heat; great thirst during relaxation of sweat and before chill begins.

Marsh intermittents, with pains in region of liver, vomiting of bile and great anguish.

During apyrexia: exhausting sweats, anæmic and cachectic appearance; sensitiveness in hypochondria; scanty urine; loss of appetite; bloated abdomen.