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When we have finished the study of Berberis we will see that it is not a very extensive remedy, but it is a very important one. Like Benzoic acid, it fits into the gouty and rheumatic sphere. It corresponds to such gouty conditions as do not determine to their proper places. A low state of the economy is present; anaemic condition; feeble constitution; pallid and sickly, old and worn out; prematurely old and wrinkled men and women. They are too feeble to determine the gouty deposits to the finger joints, where they naturally belong, and the trouble is yet, as it were, wandering around through the economy. Wandering pains in the nerves, and nerve sheaths. The wandering, stitching, tearing, twinging pains that run through Berberis are found in old gouty constitutions, and that is where we get the greatest benefit from Berberis. Its proving would lead us to see it is similar to the wandering, twinging and tearing pains of old gouty constitutions, in persons who are pallid, and sickly, and chilly, where the deposits have not been so marked in the joints; but where the twinging in the fingers and in the, toes are just such as are found where the deposits do exist. Of course in all of the gouty states we must look to the liver and kidneys for pains and various distresses; they are centers of observation, because these organs are more or less disturbed. And very often cardiac troubles go along with them. The kidneys, liver, and heart are more or less disturbed in their functions and we see that Berberis takes hold of these organs. We have the uraemic state, and the state of disorder that ends in these conditions. We will have twinging pains along with kidney disturbances.

Irregularities of the urine. Copious discharges, alternating with scanty discharges. Light urine, and heavy urine, excessive deposits of uric acid and urates. It is changeable, like Benzoic acid. These two remedies run very much together, yet their symptoms are wholly unlike. We find among these sensations that stitching pains are found in almost every region of the body, and they are all the time changing. Wandering and stitching pains; little twinges. As you sit by his side and talk to a gouty patient, "Ow," he will say. What does he mean by it? He has had one of those twitching pains. The next thing he knows it is in his knee; then it is in his toes; then it is in his head, all over him. Finally the gouty deposits become prominent in the fingers, and after the gout has determined itself, then we have sore fingers; but these correspond more particularly to Ledum, Sulphur, Æsculus and Lycopodium, where the disease has become marked and has located in the joints. In Berberis these twinging, tearing, stitching, burning pains are everywhere, they never remain in one place, but are always moving, and they are not often affected by motion. Whether he moves, or keeps still, they keep coming. In a few instances we have pains aggravated by motion, but a very few in proportion to the many pains in Berberis. He moves many times, because he cannot keep still. He moves, because he suffers. There are also many pressing pains. But the burning, stinging, tearing, stitching, wandering pains are the main 'feature, the grand feature of Berberis.

If you single them out in places, in a given joint, from that one joint they will radiate in every direction. If it is the knee joint, they will go up, and down, and every way; if it is the finger joint, they will run in every direction. If it is the kidney, they will go down the ureters; if it is the liver, they will go down into the abdomen in every direction. "Radiating from a particular point," is a distinguishing feature, and it puts Berberis almost alone for radiating pains. This is such a strong feature that Berberis has cured renal colic in many instances because of its well-known ability to shoot out in every direction. It cures gall-stone colic when these little twinges go in every direction from that locality. We see these twinging, shooting pains in gouty constitutions are associated with urinary troubles, and with liver troubles, and we begin to lay a foundation for the study of Berberis.

The joints sometimes swell. "Enlargement of the joints." But the swelling is not so common as the pains without swelling. Soreness, lameness in the joints, with these radiating pains. There will be burning, stitching, tearing, and the pains will radiate and appear in one part of the body then in another. "A pain in the heel as if it were ulcerating," and then the pain shoots off in every direction. Numbness. Lameness. As to the heart, the pulse becomes slow. Very often it is slowed down astonishingly.

The mental symptoms are very defective, that is, we do not know the mental symptoms. There are a few. We know this, that the mind is weak, that he is unable to sustain a mental effort, and that he is forgetful. "Defective recollection and weak memory. Terrifying apparitions in twilight." It is not a strange thing for a child in the dark to imagine all sorts of things, because they have heard graveyard stories from old people; but with this remedy between the daylight and darkness he sees ghosts, imaginary forms coming round him. It has melancholy, apathy, prostration of mind. Some dizziness. The headaches are of the same character as the general pains in uraemic subjects, where there is plenty of sand in the urine, red pepper deposit. The head comes in for its share of these wandering pains. Stitching, tearing, twinging in the scalp; in the skull; in the eyes, ears, back of the head. Burning pains. "A feeling in the head as if it was becoming larger," is a peculiar symptom; a puffy sensation. Always putting the hand to the head; it feels as if he had on a skull-cap. It fits down over the brow, and it is not an uncommon thing with such patients to put the hand to the head to take off the cap. "Feels as if he had a cap on the head," when there is none there. This symptom is not always described like a cap on the head. It is convertible into numbness of the scalp; many patients describe a sensation of numbness in the scalp, as if they had on a cap. Sometimes patients will deny that it is a sensation of numbness, and say it is just a cap. At one time I fully believed the "cap" belonged to two sensations. If it was painful I placed it under "pressure." If it was not painful it was supposed to belong to "numbness;" but I have now made a new rubric, "the sensation of skull-cap," which I now think is entirely distinctive from numbness; but they both have to be compared.

Then the eyes take on that same gouty condition, with stitching, tearing pains, twinging pains, shooting pains. Shooting off in various directions. There is one grand feature about Berberis, that it has no particular direction; it has all directions. Most remedies have pains taking a direction from one part to the other, pains going from the eye to the temple, etc., but in Berberis it cannot be said the pains go to any place in particular. They are wandering pains and they radiate. Pains in the ears of the same character. In every part of the body we have these twinging, tearing, burning, shooting pains coming and going, causing the patient to scowl and make a sharp noise.

The patient has a sickly look; face pale, earthy complexion, with sunken cheeks and hollow, blue-encircled eyes. That is a description of a sick face. Berberis has been very useful in phthisical conditions; and in the pains, and twinging, and sufferings in persons who have been operated on for fistula in ano. When the fistula has been closed, these pains will come if it is a Berberis case. The kidney manifestations will come on, or the liver manifestations, or the enfeebled heart, or these wandering pains. At one time feverish, full of pains, with violent thirst; alternating with the very opposite state. Prostration and aversion to water. Want of appetite at one time; canine hunger at another. The stomach is disordered, digestion is slow and feeble, and we have manifestations usually known to patients as "bilious." Eructations that are bitter and of bile.

The liver is full of suffering. In the liver we have these pains, and added to them sudden stabbing like a knife puncturing the liver. Shooting, tearing, burning, stitching, twinging pains, wandering from one place to another. "Gall-stone colic." These pains with jaundice. The liver seems to slow down in its actions, and the patient becomes jaundiced. The stool becomes white, bileless. "Sharp, pinching pains in the liver, which come suddenly and with great severity. Violent stabbing pain in the region of the liver, taking his breath away. Had to bend double." These pains last a moment and pass away. In gallstone colic pains are spasmodic, increase in intensity and diminish, but do not let up entirely. Berberis when it is indicated will let the little gall-stone loose, and it will pass through, and the patient will take a long breath and wish he had sent for the doctor sooner. Anything that is spasmodic can be relieved instantly.

Pains through the abdomen. Copious, thick, mushy stools, and these are yellow, like yellow corn meal mush. "Diarrhoea; mush-like yellowish discharges." "Clay-coloured." From what we have seen it is not surprising that it is clay-coloured, that it is bileless, that it is white. The action on the liver does that. When you have these symptoms associated with radiating pains, and with wandering pains in broken down constitutions, persons who are suffering from cold, who are pallid and sickly, you have a Berberis case.

Then the patient becomes constipated, but the stool is white, or very light coloured. "Burning, stinging pain before, during, and after stool." Enlargement of the prostate gland, which causes a constant pressure in the perineum. Pressure as if there were a lump, or as if something was pressing down." "Tearing extending around the anus. Herpes around anus. Fistula in ano." Now the surgeons nearly all advocate that if there is a fistulous opening around the anus it must be operated upon. Homoeopathy cures such cases. I have not operated on one for twenty years. The remedy that is indicated for the patient will cure the patient, and the fistula. Above all things, they should not be operated on. To close up that fistulous opening, and thus neglect the patient, is a very dangerous thing to do. Knowing all that I know, if such a trouble should come upon me and I could not find the remedy to cure it I would bear with it patiently, knowing I was keeping a much less grievance. Nor could I advise my patient to have a thing done that I would not have done upon myself. It is a dangerous thing to operate upon a fistula in ano. It is a very serious matter. If it is closed up, and that patient is leaning towards phthisis, he will develop phthisis; if he has a tendency towards Bright's disease, that will hasten it; if he threatens to break down in any direction, his weakest parts will be affected, and he will break down. Occasionally time enough elapses so that the physician who is ignorant does not see the relation between the two. But now that you have heard it, you can never forget it.

And then the kidneys and the urinary organs come in for their troubles. There is such a soreness in the lumbar region, in the region of the kidneys, that he can bear no pressure. He cannot step down from a carriage to the pavement without letting himself down very carefully. A jar is a great shock to him, and sometimes the soreness is so great that he almost faints. Soreness in the back; in the muscles of the back, and in the region of the kidneys; and this associated with all sorts of disturbances in the urine, with excessive deposits. The kidneys radiate in every direction. Pains run up into the kidney, and they become worn out if he does not get relief, he will have some serious disease. Hence we have these symptoms. "Burning and soreness in the region of the kidneys. Burning stitches, single or several in succession, in region of loins and kidneys. Much pain, soreness and tenderness in back, in the region of the kidneys. Sensitiveness in the region of the kidneys so great that any jarring motion, riding in a wagon, jumping from it, was intolerable. After kidney complaints, a foul, bitter taste, rush of blood to the throat. Great urging, with pain in the neck of the bladder, with burning, scanty urine. Violent, cutting, tensive pain, deeply seated in left side of bladder, at last becoming a sticking, obliquely in female urethra, as if in its orifice, lasting a few minutes." Now we see how these symptoms manifest themselves. Sore, inflamed, sensitive kidney, one or both. And then, the formation of little calculi in the pelvis of the kidney, little stones like pinheads; and every now and then one of them takes a start down the ureter to the bladder, and, oh, how he suffers. Then it is that the pains in the kidneys radiate in every direction. Pains run up into the kidney, and down into the bladder. In the male they appear as if they ran down the spermatic cord into the testes, and he is a great sufferer. You will be astonished to know how quickly Berberis will relieve this particular kind of renal colic. Burning pain in the bladder; burning pain in the kidney. "Urine dark, turbid with copious sediment. Urine very slow to flow. Constant urging." The bladder becomes very irritable. Catarrhal conditions of the bladder. Smarting, burning, stitching pains. Many troubles, pains and aches in the spermatic cord and testes in gouty constitutions. Burning pains along these regions.

Berberis especially fits a woman who is tired, with a gouty constitution; though not old in years she is physically tired, so that all of her domestic affairs fret and tire her. Coition becomes painful, and she has an aversion to it. The orgasm is delayed, or is entirely absent, and she is prostrated by it. In all the affairs of her innermost life she is a drudge. Full of twinging pains in all of her nerves. "Burning in female urethra. Burning pain in the vagina." A lack of sensation normal to these parts in the woman.