Acidum phosphoricum is an excellent remedy in such fevers, when they arise from grief, deep and gnawing sorrow, anxiety and care, and are accompanied by great restlessness, a pushing and tumult in the blood, and profuse sweats. The fever generally consists of alternate chilliness and heat, strong, irregular pulse, and extreme apathy. The pressing headache is likewise present, but more in the vertex than in the forehead, and is accompanied with a sensation as if the brain were bruised. The whites of the eyes are of a dingy yellow, the eyes are faint, without lustre, sunken, surrounded with bluish circles, and making the face look pale and sunken. The thirst is greater than the appetite, which is constantly accompanied with nausea; after every meal the patient experiences a painful pressure in the pit of the stomach which is increased by contact. Characteristic indications are the burning in the abdomen with sensation as if it were distended, especially in the umbilical region, and the discharges by the rectum of white-grey mucus.

One of the principal remedies in gastric fevers, and indeed in many other affections of the mucous membranes, is Arsenic. It is indicated by an excessive prostration of strength which is by no means proportionate to the intensity of the other symptoms, by great dry and burning heat, and panting for drink; a number of other symptoms which do not generally belong to gastric fevers: such as tearing, burning pains in the extremities, spasms, pressing headache, loss of appetite, evanescent sweats, anguish, etc., are likewise present and, by a process of metaschematismus, invade other parts and internal organs. Arsenic deserves especial consideration when the gastric symptoms are accompanied with violent burning pains in the stomach and pit of the stomach, swelling and pain of the liver and spleen, meteorism.

The following remedies which are likewise useful in some forms of gastric fever, will be spoken of more in detail in the subsequent paragraphs: Veratrum, Belladonna, Cocculus, Mereurius, Staphysagria, Digitalis, China, Taraxacum, Asarum, Ignatia, Colchi-cum.

§ 45. If the bilious symptoms be the most prominent, Chamomilla is a principal remedy, especially if the fever originate in violent chagrin or vehemence and be characterized by great general heat, burning of the face and eyes, violent thirst, bitter bilious taste in the mouth, vomiting of a substance which is bitter as bile, thick, yellow coating of the tongue, tension of the abdomen, and the hypochondria, colicky pains in the abdomen accompanied with rumbling, watery, green, yellow evacuations, startings as if in affright, tossing about during sleep, sallow, yellowish complexion, excessive irritability and sensibility to pain, painful pressure at the stomach as from a stone, with shortness of breath and anguish. Only in case Chamomilla should have been used as a tea previous to the arrival of the physician, it ought not to be administered as a remedy.* In such cases Coffea, Ignatia, Nux, Cocculus, Pulsatilla are better indicated.

Ignatia is preferable to Chamomile, when the bilious fever has arisen from concealed chagrin and when the usual Chamomilla symptoms are moreover accompanied with silent grief and shame. If the fever was occasioned by chagrin with indignation, Staphysagria is the remedy. Staphysagria is likewise indicated when the disease commenced with fainting fits.

Mercurius deserves especial consideration, when the gastric-bilious condition is accompanied with frequent diarrhoeic stools of green mucus which is sometimes acrid and streaked with blood, the discharges being almost always preceded by a painful pressing in the rectum and an anxious tremor with colic; the patient is moreover affected with a jaundiced colour of the skin, yellow-coated tongue, bitter taste and eructations, desire for sour things, great sensitiveness of the region of the liver which is painful and distended, the urine is dark and has a putrid smell.

China deserves consideration in cases of debility occasioned by the use of cathartics and emetics, (it will therefore have to be frequently employed in gastric fevers which had been treated in the usual old-school fashion) and when the following group of symptoms occurs: Dulness and want of clearness in the head, vertigo when raising the body, tearing headache, especially at night; restless, unrefreshing sleep, clay-coloured, yellowish tinge of the skin, and whites of the eye; yellow coating of the tongue, dry lips, want of appetite, bitter eructations and taste, retching and pressure at the stomach, oppression of the chest, frequent whitish or greenish-yellow stools, emission of fetid flatulence, which affords no relief; dark red urine, slight thirst, great debility, disposition to be vehement and out of humour; enlargement, and induration of the liver and spleen.

* As a general rule; but there are cases of bilious fever or bilious colic where Chamomile tea has been used without effect, and where the homoeopathic preparation of that drug effected a cure. Such cases have occurred in my practice at any rate. - Hempel.

If the gastric and bilious symptoms be accompanied with violent cutting pains in the abdomen which appear at intervals and seem to proceed from flatulence; if there be an entire want of action in the rectum, constipation or else greenish-yellow diarrhoea with loud rumbling and frequent emission of flatulence; if the abdominal pains be so violent that the patient is on the point of losing his senses, and the body becomes cold; if the patient have an anxious, irritable, hypochondriac mood: Veratrum album is frequently the best remedy.

§ 46. We sometimes meet a peculiar form of gastric fever, which was formerly termed febris venoso-gas-trica. This kind of fever is almost always preceded for a time, often even for years, by the symptoms of predominant venosity and abdominal plethora, which is easily increased by an error in diet, or by other hurtful influences, and, in that case, gives rise to febrile phenomena and to derangements in the digestive and the portal system. The fever is obstinate and remitting, the patient's countenance is red and puffed, he is anxious, out of humour, melancholy, the bowels are slow, the tongue is coated, the appetite is gone, there is nausea, changed taste, without, however, any evidence of undigested food having remained in the intestinal canal, the pulse is mostly hard, small, not frequent, the urine is either not altered or else dark and smells like horse urine, there is not much sweat, and sometimes the sweat is cold. After the fever has lasted about a fortnight, the patient discharges a considerable quantity of fetid, bilious, or slimy substance; these discharges relieve the patient and generally break the fever. We have already mentioned that Pulsatilla is a chief remedy in such fevers; but Digitalis is likewise recommended. It is especially suited to individuals with sanguine temperament and soft, flabby muscles, slow pulse, weak stomach, nausea, bitter mouth in the morning on waking, vomiting of the ingesta, spasmodic griping, tearing pain in the stomach, sensitiveness of the pit of the stomach to pressure, vertigo, aching pain in the forehead over the eyes, great debility as if one could not stand upon one's feet, little sleep and anxiety. Among the other remedies, we distinguish Nux vom., especially when the small of the back is weak; and a pain as if bruised is experienced in that region, Verat. album, Belladonna, Bryonia, Chamomilla, Rhus tox., Capsicum, Arsenicum, and especially Sulphur; this latter remedy is a specific remedy in this disease arising from chronic abdominal plethora, which is frequently accompanied by haemorrhoidal affections.