I have of late tried _Blatta orientalis_ indiscriminately in almost all
cases of asthma that have come under my treatment, and I am glad to say
I have received good results in most cases, as the reports of some of
the clinical cases will show. I have not come to any definite use of
this drug yet, but I shall only mention a few facts that I have observed
during its use. It acts better in low potency and repeated doses during
an attack of asthma; when the spasm subsides, the terminal asthmatic
cough with wheezing and slight dyspnoea, etc., is better relieved with
higher potencies; the low potency, if continued after the spasmodic
period is over, will make the cough more troublesome and harassing to
the patient and the expectoration tenacious, thick and very difficult to
raise, but this will not be the case if the potency is changed. I had
this difficulty in a few cases when I was less acquainted with the
action of the drug, but now I manage my cases better. In four patients
who continued the drug for some time in the low potency, during the
paroxysm and after it was over, the cough became dry and hacking with
little or no expectoration, the streaks of blood appeared in the sputa,
which the patients had never observed in the course of their long
illness. This appearance of blood in their sputa was the cause of a
great anxiety to them and made them hurry over to my office. On inquiry
I learned from two of them--one a lady and the other a young man--that
while taking this remedy they felt a sensation all over the body, for
four or five days previous to the appearance of the blood, as if heat
were radiating from the ears, eyes, nose, top of the head, palms of the
hands and soles of the feet. They attributed this sensation of heat all
over the body and the appearance of the blood in the expectoration to
the drug. I directed them to stop the medicine at once; this they did,
and with the discontinuance of it the blood disappeared from the sputa
as well as the sensation of heat, but to me it was an open question
whether this appearance of blood in the expectoration was due to
overdrugging, although I must say that the presence of the streaks of
blood in the sputa of asthmatic patients is not an uncommon phenomenon.
I resolved to give the same potency to the same patients after the
lapse of some days. I did so, and to my surprise the blood-streaked
sputa again appeared after they had taken the remedy ix, one grain four
times daily. From this the patients understood it was the same medicine
that had been given to them on the last occasion and begged me not to
give it again, as the appearance of blood in the sputum frightened them,
in spite of all my assurance. No more strong doses of the drug were
given to them and they did not notice any more blood in the sputum. I
have heard other patients complain of this peculiar sensation of heat
whenever strong doses were given to them for some time. It acts better
on stout and corpulent than on thin and emaciated persons. The asthmatic
patients subject to repeated attacks of malaria derive less permanent
benefit from the use of the drug. So, it seems to me, that in haemic
asthma, which is due to the abnormal condition of the blood, it is
efficacious. I have also used this drug in troublesome cough with
dyspnoea of phthisical patients with good result.