§ 89. China cachexia.

A China cachexia is an intermittent fever which has been treated with large doses of Quinine, without getting well, and has become complicated with the symptoms of a China poisoning.

A China cachexia requires the greatest discretion and circumspection on the part of the physician. It is a threefold complication of disease: the original fever which is scarcely yet recognizable, the morbid disposition originally existing in the organism, and having become roused by the fever, and the poisoning by the drug. The first thing to be done is to remove as much as possible the effects of the China, in order to obtain a distinct image of the original disease. Those effects cannot be expected to disappear entirely, because they are too intimately interwoven with the symptoms of the roused psora. Nevertheless, the remedies have to be chosen with a direct view of eradicating the effects of the China from the system. Among those remedies the true antidotes to China are the first to be used.

One of the first remedies against a China cachexia is Belladonna, especially when the following symptoms prevail: extreme sensitiveness and irritability of the nerves, langour of body and soul, excessive sensitiveness to the least noise, and to impressions of any kind received through the senses; tremulous weakness in all the limbs, dilatation of the pupils, dim eyes, which are surrounded with blue margins; bloated, livid countenance, yellow tinge of the whites of the eyes: tearing headache, which returns at regular periods, and affects the nerves very deeply; it is especially felt in the temples, and is reproduced or aggravated by the least noise; great debility and drowsiness, without being able to sleep; or, if sleep should set in, it is a restless kind of sleep, disturbed with anxious frightful dreams, or by paroxysms of real anguish, or by sudden flushes of heat. The nervous erethism manifests itself particularly by a moaning, anxious and oppressed breathing. An absence of irritability, especially in the muscular fibres of the intestinal canal, as indicated by constipation, is no counter indication for Belladonna. A characteristic indication for Belladonna is the following symptom, when arising from an abuse of China: distention of the abdomen, especially in the region of the transverse colon, which protrudes like a pad, and is very painful.

A second important antidote to China is Ferrum. It is indicated by congestion of the head, distention of the veins, heaviness of the head, and a beating, hammering headache; livid, jaundiced complexion; bloat -edness of the face, especially the eyes; pressure in the abdomen and stomach from the least nourishment; tension of the abdomen under the ribs, and especially in the right hypochondrium, causing asthmatic sufferings and anxiety; vomiting of food, want of animal heat, paralytic weakness of the whole body, or of parts of the body.

All these, and the following remedies, may in almost all cases be preceded by a few doses of Ipec. at intervals of two or four hours, or by Arnica, except when well marked and characteristic symptoms should require the immediate exhibition of some other antidote.

Veratrum album antidotes the coldness of body and the cold sweats produced by China, provided all the other symptoms correspond.

Pulsatilla may be given under the following circumstances: the food tastes bitter, the taste is otherwise natural and correct; the fever generally comes on in the evening, and is accompanied with the following symptoms: pale countenance, vertigo, with stupefaction, painfulness and heaviness of the head; painful oppression of the chest, moist cough, vomiting of mucus, diarrhoea, sopor. Arsenic is to be resorted to when the febrile paroxysms are not very violent, when the coldness is less marked than the heat, which is burning and of long duration, without much sweat, and when other painful symptoms were either present before the paroxysm and are aggravated by it, or supervene during the paroxysm. Scarcely any remedy is more efficient in removing secondary paroxysms of fever than Arsenic, although other medicines may seem to be indicated by the symptoms. The higher potencies of Arsenic are not as efficient as the lower for such purposes; we have found the tincture of Arsenic the most adapted to our use.*

Staphysagria cures fevers which reappear after having been suppressed by Quinine, when the following symptoms occur: the cold stage comes on in the evening, without any subsequent heat, and accompanied with scorbutic symptoms.

Sulphur is indicated when the well-selected remedies do not act, and this want of action manifestly depends upon an excited psora. These fevers generally have an irregular type, are accompanied with great erethism of the circulation, distention of the veins of the hand, slight convulsive jerks in the limbs, all these symptoms appearing mostly at night.

Lachesis has been recommended in China fevers with any type, especially, however, quartan, setting in with twitchings during the chilly stage, and thirst during the heat. Secondary symptoms are : drawing in the back and extremities, loss of appetite, vomiting, hickup, anxiety and uneasiness, as from apprehension of some accident, violent headache, deep breathing, moaning, etc.

Calcarea may be given for the same symptoms as Sulphur, especially when occurring in young, plethoric subjects, children and delicate women.

§ 90. There are other drug-diseases besides those of China. Such diseases may be caused by the abuse of natural and artificial mineral waters, either when used as baths or drinks; by the external as well as the internal use of the mercurial preparations; Opium, Valerian, Digitalis, and others. These artificial diseases can only be removed by the antipsorics. In treating diseases which are complicated by drug symptoms, the physician ought to commence the treatment by antidoting the most prominent of the latter symptoms; to accomplish this, now one, now the other medicine will have to be used, according as the symptoms which require to be antidoted can be manifestly traced to one or the other drug. We shall afterwards recur to the special cases of drug-diseases, and shall then indicate their treatment more in detail.

* This may be true, and yet I recollect a case of fever which had been treated for four months in succession, in the New-York Hospital, with large doses of Calomel, Quinine, blisters, emetics, and the whole host of allopathic deviltry, without the least benefit to the patient, and which I cured with two doses of Arsenic, 18. The symptoms were: violent chills, with bilious vomiting and tearing in the limbs ; burning heat of the skin, burning tongue and mouth, unquenchable thirst, sensation as if fire were coursing through the veins and epigastrium, anguish, horrid hammering in the temples, profuse sweats, debility, etc. - Hempel.