Homeopathic Therapeutics in the field of Endocrinology

 Author : Dr. Herbert A. Roberts

 very important chapter from the book "the principal and art of cure by Homeopathy " i am sharing this chapter with all my readers

The viewpoint of the modern physiologist reflects the theory that the vast majority of human ills are traceable to dysfunctions of the glandular system; that most growth problems (over- and under-development of the whole body or parts) and many maladjustments of the child to its environment, and even of the adult to his relationships and problems, are related in some degree to endocrine imbalance. The modern student of homoeopathy may have learned to scoff at the philosophy of Hahnemann, yet how close the endocrinologist's findings are to the teachings of Hahnemann - that the human being is a unit, mind, body and spirit - and that these are so correlated as to act freely and without impediment when the vital principle, the spirit-like force or dynamis, is in equilibrium; yet if this equilibrium of health be thrown out of balance by the dysfunction of one member (or if this imbalance be manifest by the dysfunction principally of one organ) the whole is affected to a greater or less degree.

So it is, also, that the function of some of the ductless glands is to secrete a minute quantity of specialized product into the system, a secretion that has a vital bearing on the health of the whole constitution. In many cases this secretion of a normal gland is so minute that it approaches the homoeopathic attenuation.

With this concept of the importance of the endocrine glands in maintaining health, and with the almost infinitesimal amount of some of these glandular secretions, we can hardly fail to see the important relationship the homoeopathic remedy may hold to the manifestations of endocrine dysfunction and to the balance of the ductless glands themselves.

In considering this vast subject it is apropos to quote from the book by August A. Werner, M.D. , F.A. C.P. , entitled Endocrinology (Lea and Febiger, 1937):

There has been much complaint from physicians in general that the literature on endocrinology is technical and difficult to understand. There are several reasons for these seeming difficulties, among which may be mentioned (1) the newness of the subject; (2) the lack of definite information as to the possible number of hormones and their functions; (3) the intricate interrelationship of the secretions of the ductless glands; (4) the difficulty in application of the results of animal experimentation to the human, which, aside from the scientific value of such work, is the ultimate object of these investigations; (5) the variation of potency of the hormonal preparations used, and (6) the difficulty of determining individual dosage, which is influenced by the degree of function of the glands of the patient, the individual susceptibilities of the patient, cellular receptivity, interaction of other endocrine secretions, and the effect of general metabolic factors and disease processes in each individual. . . .

To be a good clinical endocrinologist, one must first be a good internist, and the time is not far distant when, in order to be a good internist, one must be a good endocrinologist. . . .

It is necessary to have:

1. A thorough knowledge of the anatomical structure and arrangement of the autonomic nervous system. Its division into two parts, viz. the parasympathetic and the sympathetic; a knowledge of the function of these two divisions which are diametrically opposed to each other when stimulated.

2. Comprehension of the function of the endocrine glands, in so far as this has been definitely or reasonably established.

3. The recognition that the intricate vital life processes of the body over which we have no control, such as the regulation of normal growth and development, the digestion, absorption, and assimilation of food and its release from the storehouses, such as the liver and muscles for the production of energy, the continuation of cardiac action and respiration at a normal rate, our sense of well being; all these and more, depend in great measure upon the maintenance of a delicate equilibrium between the two divisions of the autonomic nervous system.

4. A knowledge that the maintenance of this functional balance between the parasympathetic and sympathetic divisions of the autonomic nervous system is markedly influenced by the internal secretions of the ductless glands which act as governors over it. . . .

There is a great clamour from the medical profession for information on treatment of endocrine conditions. Before we can treat any abnormal condition successfully we must first have knowledge of the syndrome and its etiology (here speaks the viewpoint of the orthodox school) and secondly, we must have potent preparations for treatment. Many endocrine syndromes have been recognized in the past before active principles were available for treatment. This condition still exists and the possession of active hormones does not always insure that relief can be given, for obvious reasons. With the desire and urge to alleviate these endocrine syndromes, all manner of glandular preparations have been utilized, many of which are inert, especially when administered orally. . . ."

In closing his Preface Dr. Werner gives credit to various members of the profession who have been of great help to him, and speaks of one member with the following significant tribute:

Where an understanding of the fundamentals of endocrinology was acquired, and the lesson was inculcated to study the patient's condition with every conceivable relationship to disease in mind and not as an aggregation of glands.

In his first chapter the author cites the influence of emotions, as well as the reaction of various drugs, on various functions, with the reflex action on the glands through the nervous system. His comments on the organs in sickness and health recall Hahnemann's observations, but in this 1937 observation Dr. Werner does not achieve the practical application of Hahnemann's logic and philosophy which seems so plain to us.

However, even a brief survey of his work astonishes us with the wide range of syndromes which Dr. Werner suggests are caused by glandular dysfunctions or are influenced by glandular preparations. These conditions range from acne to hæmophilia, from anæmia to deformed and distorted skeletal formation in children or developing in adult life. This implies that a vast array, if not the majority, of constitutional afflictions are due to glandular dysfunction, and therefore we may assume that the constitutional homoeopathic remedy will have its usefulness here in the light of modern knowledge just as it has had in the past when we did not realize the importance of a knowledge of endocrinology, but trusted to the totality of symptoms as our sure guide in prescribing.

There is little doubt that the majority of cases of over- and under-development of tissues or organs such as adiposis, obesity, inhibition of or precocious development of sex characteristics (whether traceable to the pineal, pituitary or thyroid glands or the gonads), and changes in the skeleton formation such as may come from dysfunction of the parathyroid, are, in the language of Hahnemann, manifestations of the miasms, either inherited or acquired. It may be circumstantial evidence for the miasm theory that certain types of manifestations are found among certain peoples, just as the types of obesity which are found largely in the Hebrew race; for one might argue with equal weight that centuries of prescribed diet might have had its influence. Nevertheless, in many cases of glandular dysfunction we are able to trace like tendencies through a family history. Sometimes in a case where no such evidence is available we may find a history, or definite evidence, of venereal infection, very often reported as cured by scientific treatment.

To the Hahnemannian homoeopath, the lack of laboratory corroboration has little weight because he realizes that the miasm may persist after the organism has been suppressed, diminished or destroyed by treatments in the infected individual or by passing through successive generations.

In any case, while the orthodox school works on the basis of the objective symptoms, merely recognizing as concomitants the subjective symptoms which to them are extraneous for clinical purposes (even while they acknowledge their theoretically correct glandular extracts as inert!) the homoeopathic school fixes its attention on the individual's subjective manifestations in accordance with Hahnemann's logical development of the therapeutic principle.

Such a book as Dr. Werner's offers us the most up-to-date discussions on the pathology, etiology and diagnosis of these conditions, but there is little real help here in the therapeutic field. Let us turn to such a book for such information as we may glean from the modern authors and research workers, but let us turn to a study of our rich fund of materia medica and philosophy when we wish to help the patient toward cure.

As an index to our cumbersome materia medica let us turn to our repertories with the constitutional symptoms of the sick individual in mind. Here we are not forced to trace the organ supposedly responsible for the manifestations in the patient; instead, we note the symptoms peculiar to the patient - symptoms mental and physical - and by meeting the symptoms of the individual with the corresponding symptoms of the indicated remedy we shall be able to meet like with like, and with reasonable assurance we can test the homoeopathic principle in these as in other cases.

Of course it is necessary in these cases, as in all others, to consider the possibility of cure, just as Hahnemann taught. This is well summed up in the concluding paragraph of an editorial in the October 1938 issue of the British Homoeopathic Journal, which we quote:

In estimating the possibility of successful homoeopathic treatment of deficiency diseases we must, of course, recognize that the action of drugs is by eliciting a response from a living cell; they cannot do this from those that are dead or restore them to life. It is of no use to attempt the impossible. But we should also recognize that no organ or tissue becomes suddenly destroyed, unless it be by trauma, and that there are all degrees of failure of function, and if the failure has not gone too far it should be, and we believe it is, possible to restore it to the normal by the giving of the simillimum. . . . To this end we need a deeper acquaintance with our remedies. We are using practically the same materia medica that we did fifty or more years ago. It requires no alteration, but it does need to be added to, not by the addition of more remedies, . . . but by fresh provings to pursue the action of our drugs into the realm of modern physiological research, and especially their action on the endocrine organs. If we do not increase our knowledge of the capabilities of our drugs our homoeopathic art will become static. It will make no progress.

It was our purpose to suggest several rubrics from both the Kent and Boenninghausen repertories that are peculiarly pertinent to the conditions we are studying, but when we were brought face to face with the widely varying array of functional symptoms manifested by these patients, it seems we can do no more than commend to you the repertories themselves, and advise the physician who wishes to cure his patient not to neglect these valuable adjuncts to successful prescribing. In other words, when a cursory glance at a modern work on endocrine dysfunction covers such a wide range of symptoms, it is impossible to limit the possible symptoms in even a few syndromes. Again and again we are faced with the conviction that we are dealing with what we have already long since learned to know as constitutional symptoms, and we cannot think of a few rubrics that might be useful without omitting others even more valuable. So we can only repeat: Learn the value of your repertory for reference work, and you will be well repaid for the time expended.

Nor can we, in one brief paper, begin to consider the syndromes which we meet in daily practice, and which we recognize as having endocrine relationships. We may only sketch a few of these conditions with a very restricted consideration of suitable therapeutic measures; and we may briefly outline a few outstanding remedies having general influence on glandular structure.

Probably the type of glandular imbalance we meet most frequently is diabetes mellitus. The accepted therapy is insulin, and it has a definite influence on the sugar output; yet few physicians pause to consider whether this treatment is curative or merely palliative - a substitution therapy. Recent experiments indicate that continued massive doses of insulin may result in an increase of sugar following an initial decrease; and that it may remain at a fairly high level so long as the insulin therapy is pushed. A case recently observed provided the interesting phenomenon of a marked decrease of sugar output when the patient was forced to do without her insulin for a few days; and that when she returned to a decreased insulin dosage the amount of sugar remained at a much lower level than while she was receiving massive doses. A series of observations on patients under homoeopathic care would be valuable.

We must remember that once insulin therapy is established, it tends to become necessary to the patient and there is little hope of establishing normal balance. Therefore it is more practical to begin treatment by the use of the homoeopathic remedy, for we can always go to insulin later if this is necessary. We find suitable remedies for Sugar in Urine in the repertories, and most of the remedies listed are deep in action or are closely related to emotional states. The diabetic patient usually presents subjective symptoms that clearly indicate the simillimum, or he may be able to give a history of emotional shock preceding his present affliction that will point the way to the remedy. It is possible that his symptoms are so clearly marked that the indications for a constitutional remedy cannot be overlooked, even though his remedy has not been proven to produce the sugar imbalance. In such case, if the patient improves on the indicated remedy, we are justified in adding it to those already listed, giving it a tentative clinical rating. If the general level of health is raised, even though the low sugar threshold remains the same, we may safely rely on the remedy which maintains general improvement, and not be too anxious over the sugar output. Recent research work has indicated the influence of the pancreas in peptic ulcer. There is probably no surgical condition which yields so readily to the homoeopathic remedy and proper diet, if it is discovered before surgery is necessary to save life. These conditions usually present enough subjective symptoms to define the simillimum from the list of suitable remedies Kent gives; in this list, too, we find the polychrests to the fore, probably with the Kali's, Lycopodium and Phosphorus leading.

It is frequently the case that in exploratory operations the close prescriber finds evidence of ulcers healed under his earlier prescriptions - in other words, homoeopathic prescribing has left its signature on diseased tissues. Another frequent exhibition of endocrine imbalance is the disturbances of the menopause. These patients give us a wealth of subjective symptoms. In fact, many of these women are so voluble that we cannot overlook that great leader among the many indicated remedies for this particular state in life - Lachesis. But a well-rounded symptom analysis may show us some other remedy to have greater applicability.

Hyperæmesis gravidarum is a serious condition we meet occasionally. If this condition is met early enough and we can find the indicated remedy, neither surgery nor yet endocrine preparations will be required. In the July 1938 Homoeopathic Recorder Dr. Allan D. Sutherland gives us the indications for Ars., Bry., Cocc., Colch., Kali c. (the sudden nausea coming on while walking and the sudden overpowering sleepiness after eating a mouthful or two); Nat. mur., Petr., Phos., Sulph., Verat. a. Many of us do not think so often of Aletris farinosa with its muscular atony and chlorotic history. We would add to Dr. Sutherland's list the nosodes, Medorrhinum, Psorinum, Syphillinum and Tuberculinum, for consideration. Dr. Sutherland is careful to point out that this is but a brief list of the possibilities; but it is valuable as a suggestion of help in critical conditions. One of the most distressing conditions we have to deal with (and one we fortunately rarely meet) is enlarged thymus. In his discussion of this condition, Werner states his conviction that it is not the enlargement of the gland itself which causes the sudden death, but that this condition is concomitant to the influence of the vagus nerve on the heart. This indicates even more strongly the necessity for the constitutional remedy for the small child, and the physician must be keen in watching his development, for all too often the child is in apparently good health until attacked suddenly and without warning. Where cyanosis, suffocative attacks or other symptoms occur, however slight, a remedy may be found that will carry the child through to normal health. If the symptoms take an asthmatic tendency we have more assurance in selecting the constitutional remedy.

In general practice we frequently meet children who are backward in mind and body. Here is a field where we are able to do remarkably good work with our remedies. The Barium salts are not sufficiently appreciated for such work, but the Calcarea group, Silica or Sulphur (to mention but a few) may be more clearly indicated. Even the Kalis and the Natrums are surprisingly successful when indicated. When the constitutional remedy is found, it is surprising how these children - under-developed, dull, stupid, unable to learn, perhaps nervous and high-strung - react to normal development. Often these children are deceitful as well as backward; then we add Arg. nit. and perhaps Bufo to our list; and if they are convulsive children these remedies may be even more strongly indicated.

A consideration of the mental and emotional states is our best indication for the simillimum. This is not as simple as to feed glandular preparations, perhaps, but it is less apt to throw other glandular secretions out of proportion, and the results seem to be generally better. And no man who has watched the action of our potencies can doubt their efficacy. To a large extent the remedies which come to mind as constitutional remedies of sufficient depth to influence these glandular conditions with their structural and nervous concomitants are our great polychrests, and many of these are from the same chemical base as the elements of the physical body - Sulphur, Silica, Phosphorus, Kali, Natrum, the Carbons. Then we find such remedies as Lycopodium, Nitric acid, and the major nosodes, of great use in these conditions. It is impossible, as well as dangerous practice, to name leading remedies for any pathological condition, and still more for any functional disturbance; yet there are valuable remedies which have a wide range and frequent usage in our daily practice that are not so valuable in these conditions.

In running over suitable rubrics for glandular conditions we find Pulsatilla conspicuous by its absence in many rubrics, and when it occurs it is in the lower ratings. On the other hand, we find Lycopodium is a leader. Lycopodium is one of the very few survivors from the first era of plant life, and it has changed very little in appearance. It has survived because of the basic qualities inherent in the development of all life, and probably, therefore, has a greater potential influence on organic functions. There is hardly an organ or function that is not influenced by that greatest of all polychrests, Sulphur. Even Hering noted its influence on such glandular conditions as were then recognized. We have spoken of its value in developing backward children. It is classical for its use in deep-seated affections resulting from the suppression of superficial symptoms. It has proven its usefulness in diabetes mellitus. We all know the classical indications for Sulphur; but in passing it briefly, we mention one function of Sulphur we may have occasion to invoke: that of stirring the organism to reaction when other seemingly indicated remedies fail to act, especially if there are recurrences of acute or subacute manifestations - where the patient moves toward recovery only to slip back repeatedly.

Phosphorus resembles Sulphur in its fields of usefulness as in many of its symptoms, while being quite different in its classical constitution. Where Sulphur is indolent, Phosphorus is over-excitable, erotic in many manifestations and erratic in most symptoms related to the sexual functions. These manifestations range from insanity or lascivious ideas to vicarious menstruation, impotence and abnormal labours. Phosphorus affects the development of the physical body in the child, his ability to concentrate his mental efforts, and the normal functioning of the adult, just as in Sulphur. Prostrated energies from loss of fluids and from emotional and physical strain are characteristic of Phosphorus, as against the general lack of energy in Sulphur. Both Phosphorus and Phosphoric acid are to be considered in glycosuria, as well as other glandular difficulties.

Nitric acid has a powerful action on glandular dysfunctions, especially of syphilitic origin, although it is antipsoric and antisycotic as well. Sensitiveness is a keynote of this remedy - of the head or of affected parts, to touch, jars, sudden motion or sudden change in tempo of motion; to cold, to changes in the weather; tendency to take cold. There is great disturbance of the circulation; the fingers and toes appear livid, pale, cold or dead at times. The characteristic sensation as of a splinter in the affected parts, particularly in such tissues as the tonsils, is found also in Arg. nit. and Hepar. In Nitric acid the disturbance of the sexual organs and functions rivals Phosphorus, and sometimes there is almost as much lasciviousness. In general the sensitiveness and excitability is uppermost, but they tire quickly; old people calling for this remedy manifest excessive prostration. "Vegetable Sulphur", or Lycopodium, is one of the great trio of remedies (Sulphur, Calcarea and Lycopodium) about which, as Clarke says, "all the rest of the materia medica can be grouped". Like the rest of the trio, it has swollen glands, and is one of the few specifically mentioned as having goitre. Acute glandular affections start on the right side and tend to move to the left. This is one of the few remedies mentioned in the materia medica as definitely tending to enlargement of bony tissue, whereas Phosphorus tends to thickening of bony tissue. Characteristically, Lycopodium has a furrowed face and forehead; thin face and neck and perhaps upper chest, while he remains plump below, or there is progressive emaciation from above downward. Great weariness and lassitude, especially in the legs after slight exertion, and great want of bodily heat; deadness of the fingers and hands as in Nitric acid; he feels as if circulation were suspended. Mentally he is as fearful as Phosphorus and the Kalis, as sad as Nitric acid and the Natrums; the burning pains make us think of the burnings of Sulphur and Phosphorus. Probably Lycopodium is the most flatulent remedy we shall consider, unless it be Carbo veg., which has more heartburn.

The general state of gloominess and mental depression characterizes the Natrum group and is their great earmark in chronic states; they almost delight to make themselves and others miserable by looking on the dark side; strong aversion to consolation; sometimes alternate gaiety and gloom. These salts are a startling exposition of the power of potentization, for in this form they have the most profound action on the mental state, on physical functions, on the chemistry of fluids and the pathology of the organs. There is sudden failing of strength, excessive draining of body fluids coming on suddenly, sudden depletion of the sexual organs because of excessive stimulation; rapid changes in the blood; sudden and profound emaciation, often following previous increase of flesh. Nat. mur. particularly, emaciates about the neck, even when eating ravenously. This group of remedies affects the thyroid gland markedly, and has the subjective sensation of compression, as if there were a lump or plug in the throat. Nat. ars. has the sensation as if the thyroid body were compressed between the thumb and finger. Nat. carb. has the hard swelling of the thyroid.

Clarke tells us, in his Dictionary, that Nat. carb. gives the type of the family group, while Nat. mur. is the most important remedy of the group, ranking with the polychrests. These remedies are exceedingly sensitive to cold; Nat. carb. is the chilliest; it cannotst and cold air, draughts, cannot stand a change of clothing or a drink of cold water because of the chill; yet Nat. carb. is unable to stand the heat of the sun and succumbs easily to heat stroke. He has no physical stamina; he exhausts quickly from mental or bodily exertion, and suffers great debility. Like the family, he is profoundly exhausted after a short walk, and Nat. carb. particularly suffers from the effects of overstudy. The nervous system is weak yet is easily affected almost to hysteria, just as in the sexual sphere there is sterility because of over-activity of the organs.

Other outstanding manifestations of the exceedingly sensitive state of the nervous system is the extreme sensitivity to music and the aggravation therefrom, and the aggravation before and during electrical storms. Like all the Natrums, there is anæmia with an increase in the white cells and decrease of red cells; with this there is emaciation and bloating. Children find walking difficult because of even weaker ankles than in Sulphur; they are disinclined to study because it is so exhausting; nervous almost to hysteria; pale, weak, easily tired, easily chilled; they bore their fingers into ears and nose and it seems to relieve. The adult Nat. carb. patient shows much the same picture, but if a man, he tends toward priapism; if a woman, there is a discharge of mucus and the semen after coition with consequent sterility; if she goes on to gestation, labour pains are weak and ineffectual and she begs for massage. The Nat. carb. patient is always spraining a wrist, an ankle, a knee, dislocating a joint or straining a muscle in the back. Nat. hypochlorosum is distinguished from the others of the family group by its rapid emaciation with a sudden, waterlogged uterus which sags into the lower pelvis with the sensation as if it would fall out; with this there is almost a globus hystericus which seems to rise from the uterus into the upper chest. Faintness, weakness and weariness, so that she falls asleep whenever she sits down, with flabbiness and a diffused hydrogenoid condition with a tendency to leuco-cytosis mark this remedy.

It is difficult to confine oneself to a brief outline of Nat. mur. Clarke tells us that it corresponds to that type of constipation which is associated with anæmia, chilliness (especially down the back) and cold feet; or to indigestion in masturbators. The degree of melancholy keeps pace with the constipation, just as in Nat. sulph. the melancholy keeps step with the degree of indigestion. Tears are a keynote of Nat. mur.: tears with the emotional depression, tears even with the laughter, for she laughs until she weeps at things not at all funny; tears with the coryza, and even with the whooping-cough. The face is earthy, dirty and greasy. The strong desire for salt is even more marked in the nausea and vomiting of pregnancy. In adults suffering from glandular imbalance, with a history of malarial fever and the classic dosing of quinine, Nat. mur. may unlock the case and even carry it to cure. The Nat. mur. child is slow in learning to walk and talk, craves salt so that he will eat it as some children do sweets, and when out of doors is apt to eat earth. We are told that Nat. mur. is the chronic of Ignatia; certainly the emotional Natrum family shows the effects of emotional strain or shock as much as Ignatia; and Ignatia, by the way, is a remedy we often overlook in diabetes following emotional shock.

Nat. phos. children develop improperly because of excess of lactic acid in their diet. It merits wider use than it has received, and its general features are marked by the parent substances. Like Phosphorus, it is effective in diabetes, but here it shows its relationship to the Natrums, because this diabetes is apt to be a reflex of hepatic derangement. There is much disturbance of the sexual organs; there is weak back and trembling limbs, especially knees, after coition and after the nightly involuntary emissions. Instead of the weak, lax muscles of Nat. carb. we find here a tension of muscles. There is inability to apply himself to his books, and even the effort causes despondency. Nat. sulph. is unusually gloomy, even for this gloomy family. It is strongly hydrogenoid in tendency; there is marked aggravation from water and dampness; he may be so sensitive to this that he cannot eat food grown on wet ground; he cannot live with comfort near a body of water. Nat. sulph. has less influence on goitre, perhaps, but there is the sense of constriction in the throat that foreshadows its usefulness in this field. It has marked usefulness in the enlargement of the liver and spleen and is almost as useful in old malarias as Nat. mur. It is particularly valuable in glandular imbalance following injuries to the head; in fact, it is almost a specific for head injuries, even long after the trauma. It has profound action on the blood, and it has proved its usefulness in leukæmia.

In his Dictionary Clarke lists twenty-one Kalis, the majority having been well proven. T. F. Allen said the Kali salts were insidious in action and destructive of every organ and tissue in the body, so it is natural they are frequently indicated in glandular dysfunction. No doubt the predominant action of the group is anti-syphilitic. There are the manifestations of primary syphilis, ulceration of mucous membranes, even destruction of bony structure as in the nose, as well as other symptoms of the miasm. On the other hand there is the marked sycotic trend as shown by the catarrhal discharges, and it has a field in acute gonorrhoea.

The chronic Kali patient exhibits the classical stature of the sycotic - rather short than tall, chubby to obesity, and with an accompanying anæmia. Here we have the perfect field for homoeopathic therapeutics in endocrine imbalance, for there is a wealth of characteristic mental symptoms varying from the dull mentality with loss of memory and inability to exert the mind, even to softening of the brain, through all the states of nervous excitability (with or without intelligent co-ordination) to the high-strung nervous patient who borders on insanity or is actually insane. These people are easily startled at the slightest noise; fearful, apprehensive, expect to die shortly and fear death. They may be as sad as the Natrums at times, but they are even more fearful. The Natrums have aggravation from mental exertion, but the Kalis cannot concentrate enough to bring on an aggravation. Clinically, the following brief summary suggests fields of special usefulness in glandular dysfunctions, and indicates further study:

Kali aceticum in diabetes. Kali arsenicum for exophthalmic goitre. They are quarrelsome, discontented, jealous; the mental symptoms recur every third day. Kali bromatum and Kali phos. are the most mentally degenerate of the Kalis; both have developed softening of the brain in their clinical picture. Both remedies have done good work in the backward children and the aged. In the adolescent Kali brom. is often useful for acne appearing at that period. Kali brom. is useful in diabetes; emissions, impotence and masturbation; and in women, affections of the ovaries. Kali brom.'s peculiar mental symptom is that, when walking, he is sure he cannot pass a certain point ahead of him.

Kali phos. has marked flushing, especially in young people - they flush and pale because of nervousness and it aggravates the nervous strain. There is marked anæmia; disturbance of the menstrual function; atrophy of the male organs; nymphomania. Sexual excitement, either indulged or suppressed, aggravates all symptoms. Kali carb. is such a polychrest that it is difficult to limit it to a brief citation without omitting salient points. However, it is marked by such a great weariness that she wants to lie down, even in the street. It is exceedingly useful in the menopause, in disorders of pregnancy and in disordered menstrual functions. It is anæmic and obese, with atony of the muscles.

Kali ferrocyanatum deserves a wider use than it has received. It was well proven by Bell, who found that "it rivals Sepia in the uterine sphere". These people are chlorotic and debilitated; they suffer from dysmenorrhoea, dyspepsia and fatty degeneration of the heart - an exemplification of Allen's estimate of the family. Kali iod. is one of our great goitre remedies and it also has atrophy of testes and mammae. Life seems insupportable to this patient; he awakens at night to dread the return of dawn.

Kali mur. is the outstanding member of this family for swollen glands; in fact, swelling is one of its characteristics, for it is very useful in swellings following blows, cuts and bruises. It may be indicated in glandular troubles following vaccination, and in Hodgkin's disease. The Kalis tend to white mucous surfaces, and Kali mur. is perhaps the most marked for this symptom. Silica has such a vital relationship to growth, development and functions of mind and body that it is difficult to limit our view of it to brief mention. It affects the development of the bony structure and teeth, and is useful in knitting tissues after operation or trauma, or in removing keloid or abnormal scar tissue. There is profound action on the blood, and this, together with its affinity for glandular swellings, is the key to its suppurative tendency. A weak spine, brain fag, feeble circulation, caries, abscesses and fistulas, hernias and even hydrocele, give some idea of its depth and breadth of action. This is one of the few remedies listed as clinically useful in elephantiasis. Remember that vaccination or suppressed footsweat may be the cause of your Silica condition, and that your Silica child is the classic problem "angel child".

The Calcarea group should be studied in these conditions. Calcarea carb., especially, has a strong resemblance in the childhood symptoms to Silica, but where Silica has the suppurative tendency in glandular symptoms, Calcarea's tendency is to indurate. Calcarea is apt to be pot-bellied; but there is the same depraved appetite as in Silica, a like relationship to growth and development of the teeth and bony structure, and as much anæmia, and even more spinal affections. It has the weak ankles and the child walks late; the child is fat, rickety, pale, and sweats profusely about the head. Calcarea's sexual organs are greatly disturbed functionally, while Silica's sexual organs are apt to be more disturbed by pathology. Calcarea is the corpulent adult with full, even pendulous, abdomen and goitre or renal calculi. We should remember the carbons - Carbo veg., Carbo an., Graph., Sepia - in glandular conditions. The major nosodes merit further study along these lines, also. In fact, all our polychrests and many of our near-polychrests will yield richly to our search for effective remedies in endocrine disorders.

As homoeopathic physicians, we have undertaken a labour that is vast in its expanse, yet it yields to us in the degree to which we apply ourselves in its pursuit. Our resources are far greater than those of the orthodox school; we have proved them to be potent in a varying range of attenuations to suit best each man's experience and requirements. Our remedies will not upset the balance of endocrine secretions, for the simillimum will fill the demands of the system in all its parts without stimulating too much those organs which have maintained a relatively secure balance. In other words, our remedies affect directly the vital energy which in itself establishes equilibrium, those parts which are susceptible because of imbalance becoming a part of the normal healthy functioning of the whole unit. Let us watch with great interest the investigation of the endocrine system, but let us look with the expectant eye of the explorer upon our homoeopathic remedies, that we may meet and cure even these little-understood conditions.