In the second stage of the disease Valeriana is frequently an efficient remedy, when white miliaria and bland delirium have made their appearance. The miliaria occurs most frequently on the chest and in the nape of the neck, it causes a burning and stinging sensation and announces itself a few days previous to its breaking out by stinging pains in the pit of the stomach and a continuous oppression of the chest; this latter symptom is greatly relieved by dry cupping at the pit of the stomach. The delirium is accompanied with great nervous erethism and tremor, and consists of illusory notions, such as: the patient is not herself, but some one else, to whom she has to give way, on which account she keeps constantly pushing towards the edge of the bed; or she is in a carriage and has to make room for some other person to come in; or some animals are lying by her side which she fears she will crush by the weight of her body, and the like.* The patient complains, moreover of great pains in the limbs, especially in the feet, which are spasmodically stretched, are extremely sensitive to contact, and resume their natural position only gradually as the patient improves. The pains which the patient experiences in the limbs, likewise involve the spinal column, decubitus supervenes very speedily. As a general rule Valeriana may be employed in typhoid fevers which commence with an irritation of the spine, as manifested by violent spasms, asthma, distortions of the countenance, etc. The appetite never disappears entirely, but the thirst is much greater; the febrile heat is continuous, the pulse being accelerated and weak, 100 beats a minute; the sleep is restless, disturbed with anxious dreams, during which the patient constantly endeavours to uncover himself. The abdomen is sensitive to the touch in the ileo-coecal region, it is generally distended; costiveness, scanty, turbid urine.

* The reader will perceive that these symptoms are spoken of as belonging to a female patient; we may infer from this that Hartmann has met such a group of symptoms in his practice in a female patient, and, having cured it with Valeriana, has inserted it here as a group of general occurrence. - Hempel.

§ 75. In typhus gastricus the following remedies are the most efficient: Ipec, Cham., Puls., Ignat., Nux, Cocculus, Arnica, China, Digitalis. Ipec. is indicated when the gastric symptoms prevail; by slimy, bilious diarrhoeic stools, occasioned by the abuse of pork and pastry (see also Pulsatilla) and appear in company with spasmodic pains. Children and females being particularly predisposed for such affections, Ipec. is especially useful to those classes of persons, and the more so when the following symptoms occur: the spasms consist in tossing the head to and fro, distorting the features, jactitating the limbs, stretching the body as if in a state of rigor (spinal irritation); starting from sleep as in affright, violent, general heat, especially in the evening hours, accompanied with great nervousness and irritable mood; yellow coating of the tongue with constant inclination to vomit, and vomiting of bilious substances, etc. (see gastric and bilious fevers).

On a par with Ipec. ranks Chamomilla, when convulsions and spasmodic symptoms occur, with bright-red, dry, cracked tongue, lined with a yellowish-white coating, slimy, putrid, and bitter taste, putrid smell from the mouth; inclination to vomit, and bitter vomiting of food; pressure at the stomach and distention of the abdomen with great sensitiveness to pressure, with cutting, burning, and pinching pains; diarrhceic stools of white or yellowish-green mucus; urine with yellow flocks; catarrhal symptoms; great nervous erethism; vivid fancies both during sleep, which is full of dreams, and in the waking state during the febrile heat which is accompanied with great thirst.

We refer the reader to the chapter on the gastric fevers for a more detailed account of the symptoms indicating the preceding as well as the succeeding remedies.

Pulsatilla is a great remedy in typhus gastricus. This remedy is adapted to persons with a mild, yielding temperament and a timid disposition with inclination to weep. The febrile heat is always mingled with chilliness which comes on as soon as the patient uncovers himself; there is no thirst; the pulse is quick and small; bland delirium, weeping, wringing one's hands, alternating with sopor.

Ignatia is adapted to persons with fitful temper, changing from mirth to sadness. The fever is almost always accompanied with sudden flushes of heat, headache, pain in the pit of the stomach, great debility, occasional alternation of redness and paleness of the countenance, dry, chapped lips, white tongue, deep sleep with snoring, accelerated small pulse, and the gastric and bilious symptoms which characterize this remedy.

Nux is equal to any of the above-named remedies in this variety of typhus; in many respects it is superior, since the action of Nux extends over almost all the organs and systems of the human organism. Pulsatilla is closely related to Nux, but more so to Phosphoric acid. The difference between Nux and Pulsatilla is more general than special. Puls, is more suitable to females, Nux more to males; Puls, corresponds to the mild yielding temper, Nux to a lively, sanguine, choleric temperament and an artful, malicious disposition; Pulsat. is indicated by predominant paleness, Nux by a bright-red complexion, and in general by plethora which, in many persons, is indicated by haemorrhoids. These are the general differences. The particular indications for Nux are the following: troublesome heat which is frequently mingled with flushes; hard, full and frequent pulse; pains and debility in the limbs, tightness and dulness of the head, vertigo, aching pain in the forehead (relieved by laying the head upon the table); oppressive crampy pains in the stomach and a tensive pressure in the pit of the stomach with nausea, bitter taste and eructations, with yellowish coating of the tongue, complete loss of appetite and vomiting of the ingesta, cutting spasms in the abdomen, constipation, painful emission of urine, which looks reddish and frequently bloody; all impressions from without are intolerable to the patient, he is deeply affected by them, he moans, groans, he becomes vehement, even unto rage.