CLARKE J. H., Constitutional
Medicine With Especial Reference to the Three Constitutions of Von Grauvogl
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Introductory
The following extracts from von Grauvogl’s
Preface to his Text-book, dated “Nuremberg,
Since Homoeopathy is nothing but a system of Therapeutics resting on the foundations of all the natural sciences – Chemistry, Physics, Physiology, etc. – a confirmation of the Organon and the proof of its conformity with natural science may be required often and at various times. And if the practice of life has a word to say, then it is the duty of every practical physician to make public the knowledge and experience which he has acquired, no matter whether at the present moment these should be regarded favourably or unfavourably; for frequently their real value is finally settled by the future only.
A text-book, however, must present examples; its principles must be demonstrated and set forth by cases and comparisons taken from life. Then everyone can accurately apply what he has learned to his patient and at the same time confirm it by the test of success.
I resign all pretence to any party stand-point, since there should be no party in science, consequently none in therapeutics…
Aside from its contents as indicated by its title, this work has also the intention to respond to the necessary though not easy demands of a medical logic elucidated by practical examples; for “opinions” – and these, unfortunately, mean nothing but faith in “authorities” – separate physicians into hostile camps and paralyse medical activity which, were it united, would always be attended by the happiest results; these, however, are not attainable under present lamentable circumstances.
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The cause of this state of things clearly cannot be in the subjects themselves about which medical factions contend, since these subjects stand to each other in the natural relation of cause and effect, but is brought about by arbitrary “conceptions” thereof. Hence the necessity is abundantly apparent of intertwining the instruments of logic with the contents of a therapeutic text-book.
Those who wish to follow the brilliant logic of Grauvogl’s treatise must be referred to the Text-book itself. One of my aims will be to “dis-intertwine” the practical conclusions from the “instruments of logic” and let the facts speak for themselves. All I will say here is that readers can trust implicitly to Grauvogl’s honesty as well as his logic. I will only add this pregnant passage from Part II, page 104 of the Text-book. Grauvogl had been citing instances where the teachings of the “physiological school, commonly called Allopathy”, were both useful and necessary :
Thus then we must sometimes offer the diseased human organism palliative aid according to the causal law, but as a rule, or course, medical help according to the law of reciprocal action [Homoeopathy] If homoeopathy should seek to treat all cases and every case simply and solely according to the law of similarity, it would fall into the same error as Allopathy. Hence these sciences are no contrasts in the sense of opposition but rather complements of each other.
This is an extremely important observation and it is purely from the want of the recognition of this truth that there was ever any opposition to Hahnemann and his teaching. Homoeopathy was simply an addition to the knowledge of medical truth and should have been accepted at that If it was incidentally the means of exploding many cherished medical “opinions” not founded on facts, then the “opinions” ought to have been allowed to pass into the limbo into which all such will eventually have to go; Instead of this we know what happened and what is happening now.
Against this devotion to mere “opinions” Grauvogl raised his voice. He also has some pertinent remarks as to what is a “Smile”. He says : “The substance of the law of similarity consists in this, that it indicates a correspondence in form which must be present for the purpose of a cure between “the dorm of the reaction against some morbid matter and the form of the reaction against some drug manifested in a proving. The law of similarity refers only to the indication, and the effect which follows is naturally not a similar but its direct contrary. Thus the strife of the Contrarium with the Simile is a strife about nothing – a strife about mere ideas of relation. The investigation of facts with a criticism based on natural laws has in all these controversies been consistently neglected”.
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Grauvogl was as true a Homoeopath as ever lived, but he never mistook Homoeopathy for being something which it is not, or ever worshipped the dogma as a kind of theological fetish. He was a truth-seeker always, and was able to find it everywhere – even in his own errors. “Errors are (or contain) often the germ of truth where the mind without a teacher is obliged to teach itself”. Lest any should think there was any weakness in his apprehension of Homoeopathic truth I will quote a passage from Part I, p. 390 :
”The doctrine of high potencies is the most glorious acquisition of Homoeopathy. It developed its greatness and might in an intellect which has lit up the path of natural science for more than half a century, without, however, having been comprehended. And what are the discoveries of the spectrum analysis compared to the discovery of Hahnemann’s high potencies?
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The morbid constitutions according to various authors
Many observers in all schools
have noticed certain tendencies to particular disease-manifestations in certain
types of individuals, and among those who have succeeded in reducing the
different forms to specific types there is a fairly unanimous selection of the
number Three.
After years of patient
observation Hahnemann saw that a superficial symptom-resemblance between
drug-symptoms and disease-symptoms was sometimes insufficient to show the true
specific correspondence. Eventually he tracked down the underlying
constitutional dyscrasiae to the three “miasms”, and he named them, Syphilis,
Sycosis and Psora. The first of these was due to the initial sore of the
chancre, the second to the constitutional effects of gonorrhoea and the third
to the chronic effects of itch poisoning. The three typical remedies indicated
in the three dyscrasiae were (1) Mercury, (2) Thuja, (3)
Bazin again reduces all chronic
diseases to three forms : Scrofula, Gout, and Syphilis, from which he thinks
that all other pathological forms originate.
Rademacher again, also found a
three-fold division. His division was an aetiological or causative one, and
varied as the peculiar cause at work In some epidemics one type would rule and
the remedy for that type would be Copper. At another season a somewhat
different type would prevail and for that Iron would be needed; for a third
again Cubic Nitre or Natrum Nitricum would be the remedy. And each of these
remedies had allied remedies of its own type.
Grauvogl, who did not deny the
value of these classifications, did not find that any of them went far enough
or deep enough. so he re-stated them in terms of the tissues themselves. He
also widened their borders.
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It was through Hahnemann’s
insistence on the necessity of observing Concomitant Circumstances in relation
to symptoms that Grauvogl was led to make his great generalisation. In the
practice of Homoeopathy it makes all the difference whether a symptom is worse
or better in hot weather or cold, wet or dry, summer or winter. Grauvogl with
his critical and analytical instincts asked himself what these conditions meant
in the organism. Being well versed in chemistry, he asked himself what changes
in the organism took place differently under these different conditions and he
tracked them down in the first place to the changes that take place in the
blood in respiration.
The animal body, solid as if
looks, is made up in two-thirds of its bulk of water. “It (water) is used for
keeping up the physical properties of the body, and renders function and
nutrition possible. It is a universal solvent chemically employed for
dissolving solid substances and mechanically as a carrier of the insoluble.
Water is lacking in no part of the organism and it is in relation to the
manifold solid matters its most universal unit. The whole nutrition consists in
the new formation of hydrates for supplying the place of that which is
dissolved and excreted, and forms by that alone an immense source of heat; the
water of the body absorbs all kinds of gases and thus alone respiration and
access of oxygen becomes possible. Every process of combustion is preceded by a
polarisation of oxygen. Ozone vanishes in the combinations which arise as
products of combustion; the antozone (positively electrified ozone) remains
with the water for which it has an affinity. The water can also supply the
place of acids and bases, and is amphoteric (both), and with a mixed food
oxygen is expired, which is followed at the expense of the oxygen contained in
the carbohydrates, while with the exhaled hydrogen a small quantity of peroxide
of hydrogen is mixed. Water maintains the equilibrium of the normal temperature
of the organism, while neither the blood nor the nerve centres alone regulate
the production of heat”.
Respiration is a function which
is not confined to the lungs, all parts of the body respire and consequently
oxygen is found in all organs and tissues, sometimes as ozone (neutral) and
sometimes as antozone (positive). The air we breathe is composed of Oxygen,
Carbon, Hydrogen and Nitrogen, of which the whole organism is composed and
which are even contained free in the blood. Thus changes of the atmospheric
constituents affects the constant whole of the organism.
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It is in this conception as
explaining Hahnemann’s observation of the effect of the various seasons and
climatic conditions on patients and drug-provers that Grauvogl’s arrangement of
the Constitutions is based. “The Homoeopath abstracts first from the symptoms
the individuality of the patients in connection with the state of the outer
world in which they have existed from their birth and out of which the bodily
constitution is developed. The bodily constitution is hence the general cause”.
Grauvogl made the true
observation that if the organism is not able to adapt itself to varying
conditions there is something wrong with the organism. “If, for example, a
patient with intermittent fever, even before his sickness, was always affected
by damp weather, he is not cured, even though the last paroxysm occurred years
ago, so long as he does not feel quite as well in damp as in dry weather.
”Or, if a patient who has been
for a long time annoyed by this circumstance that every draught of air affects
him unpleasantly, he is not cured, even if, for instance, many years have
elapsed since he recovered from his last pneumonia. As long as the disposition
to take cold is not removed from him, every relapse to which he is exposed
under such circumstances is proof of the still present conditions for the same
or a similar disease, and hence a proof that he is not wholly cured.
”Such constitutional conditions
which make themselves known by such accompanying circumstances, give us, hence,
the only right indications”.
No further elaboration is needed
in order to show how the mind of von Grauvogl worked to map out the “general”
and to find the basic remedies for the constitutions out of which arose such a
multiplicity of apparently different diseases but really only different
manifestations of one and the same disease.
As a sample of that I may refer
to Case IX, p.
PAGE 7
Before passing on to a
consideration of the three constitutions themselves there are one or two
pregnant passages which it is well to put on record here.
”Every living organism moves
within oscillatory rhythm within various spaces of time from one position of
equipoise to another. We see this in the rhythm of the motions of our solar
system eve, and in its influence excited through the movements of the moon and
the earth upon ourselves. But no oscillatory rhythm of life remains the same;
it never returns again to the point which it last reached”. (§ 200).
I have put on the title page a
sentence from Paracelsus which might have been used as a text for the following
:
”To understand a diseases or a
cure is utterly impossible if one does not know the history of its development.
But where is the historic knowledge with regard to Pathology and Therapeutics
which possesses the key to these histories of development? No Clinic speaks
thereof. The lectures of the Professors are silent”. (§ 290).
”Acute diseases run their course
so to say in the track marked out by the bodily constitutions”. (§ 291).
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The three constitutions of grauvogl
We are now in a position to
approach definitely Grauvogl’s own arrangement f the morbid constitutions
according to excess or deficiency of certain elements in the tissues and blood.
For every organ and every tissue breathes, and if the lungs are the gate-way
and the blood the carrier it is the tissues which are the ultimate recipients
of the oxygen that is in breathed.
1. The Hydrogenoid Constitution
is characterised by an excess of Hydrogen and consequently of water in the
blood and tissues.
2. The Oxygenoid is
characterised by an excess of Oxygen, or, at lest, by an exaggerated influence
of Oxygen on the organism.
3. The Carbo-nitrogenoid
Constitution is characterised by an excess of Carbon and Nitrogen.
The Hydrogenoid Constitution
corresponds closely with Hahnemann’s Sycosis but it covers a much wider area and,
is not by any means confined to the acquired or inherited results of
gonorrhoeal infection. Intermittent-fevers and periodicity come within its
sphere.
At the present time Vaccinosis,
or the constitutional sufferings from cow-pox infection, should certainly be
included under this heading. The antidotal relation to it of Thuja, which is
one of Grauvogl’s principal remedies for Hydrogenoids is a clear indication
that this is so. Moreover, Burnett told me that he regarded Gout as belonging
to the Sycotic diseases.
The Oxygenoid Constitution is
Hahnemann’s Syphilis but we have no examples of its treatment as we have of the
other two.
The Carbo-nitrogenoid
Constitution is Hahnemann’s Psora.
I will now let Grauvogl describe
them in detail and give examples of their treatment – at least of the first and
third.
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The Hydrogenoid is the one most
fully elaborated and illustrated by a great wealth of clinical cases. It is
also illustrated by cases from other writers, making altogether as fascinating
a clinical record as it has ever been my lot to peruse. Parts of it had been
already familiar to me but I may here confess that this is the first time I
have ever had an opportunity of putting the experiences in their proper
setting. I trust it may prove a worthy one and as helpful to others as it has
been to myself.
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The hydrogenoid constitution
Von Grauvogl shall now speak for
himself :
”This much has become clear at
any rate from the investigations which have been made, that there is a constitution
of the body which in many cases is the product of gonorrhoeal contagion. But
one would greatly err, as already said, in concluding therefrom that in this
matter the question were only as to the consequences of a sycotic contagion.
For the causes of those diseases which Hahnemann arranged under the head of
Sycosis is not the only cause of the development of this state of the body
which is distinguished by a too great proportion of water, or by hygroscopic
blood.
”I always recognise this
constitution of the body by the circumstances accompanying any disease
whatever, and for which I always inquire as soon as the patient has told his
complaints.
”If the patient states, that he
feels worse in cold, or damp weather, and in the rain, then I know that I have
to choose among the remedies which are similar to his disease, such only as
contain a greater percentage of a combination of O with C and H, consequently
produce more heat and diminish the influence of the water. Hence the symptoms
of a disease in this constitution of the body are aggravated by everything
which in any way increases the atoms of water in the organism, by baths, for
example, and that all the same whether they are mineral baths or simple water
baths; or whatever increases the attractions of the organic molecules for
water, as, for example, the eating of animals which have lived in the water, as
fishes, etc. All diseases in such constitutions are increased by cold, also by
cold and cooling food and drinks, for example, sour milk, hard eggs, cucumbers
and mushrooms, but chiefly by living near water, and especially standing water.
”This experience is to me of all
the more inestimable worth since I have quite cured many, very many patients
simply and solely on this ground, who have been sent for years by other
physicians from one bath to another, where they never found any relief and
often the most marked exacerbation of their sufferings.
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”Another sign that a disease has
occurred in such a bodily constitution I find in the periodicity of its
phenomena, and chiefly in its irregular and paroxysmal course. For even the
nervous system which, next to the brain in proportion to the other parts of the
body, possesses by far the greatest percentage of water reacts on a plus of
water with an energy commensurate with that with which it carries over its
reflex influence on the blood and other organic formations. The experiences of
Rademacher and Hahnemann agree with this also, and these, naturally, should
stand much higher in the regard of practising physicians than the researches of
experimental physiology. I do not mean by this merely the one, two, three, four
or eight day exacerbations and remissions, but even those periods during which
for a still longer time no disease seems to exist, and this extends even over
months.
”Hence for the sake of brevity I
distinguish this constitution of the body, according to its causes and
conditions, as the Hydrogenoid.
”I wish also to call attention
to the effect of the electricity of the earth, for those nervous affections
which are exacerbated by electric disturbances appear under this bodily
constitution.
”In cases where there is a
combination of the hydrogenoid and carbo-nitrogenoid constitutions the
Hydrogenoid must be cured first and then the Carbo-nitrogenoid. This
corresponds with Hahnemann’s directions regarding Sycosis and Psora – Sycosis
was to be dealt with first. [The same applies to Vaccinosis. – J.H. C.]
“In regard to the Remedies for
this constitution, those substances must be curative of it which prevent the
influence of the water on the blood, and here above all others I reckon
Glauber’s Salts – Natrum sulph. The correct indications escaped Rademacher’s
adherents only because they will not use a “fool’s dose” as they name the Homoeopathic
dilutions, whilst in their doses, that is the purgative doses, Glauber’s Salts
cannot manifest that effect.
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”Since in this constitution in
which Hydrogen frequently seems to have usurped the place of Nitrogen the
problem is not only to diminish the influence of the Hydrogen but, where it is
possible, to preserve at the same time tissues rich in nitrogen, Nat. sul.
recommends itself all the more as Prof. Seegen has given experimental proof
that by its action the exchange of the nitrogenous tissue-elements is
considerably curtailed, the animal body becomes richer in nitrogenous atoms,
gelatine and albuminous bodies, and that during the use of Nat. sul. the
elements of the body free from nitrogen, and especially the fatty tissues, are
more freely exchanged.
”If we know, further, that the
alkalis essentially promote the operation of oxygen by means of the respiratory
process, it is clear that if we compare the various localisations of the
pathological processes in these constitutions and their specific forms with the
Homoeopathic drug-provings, then even Nat. nitric., Nat. carb., Nat. acet., and
Sal ammoniac (Ammonia muriatica) especially belong here.
”Moreover, in this series we may
mention as nutrition remedies – [Grauvogl divides remedies into functional and
nutritional] – Calc. carb., Mag. carb., Mag. phos., and Silica.
”Then for other reasons adduced,
Iodine, Bromine, Chlorine, Nitr. ac., Borax, Antimony, Alumen, Thuja, Carb.
veg., Arnica, Aranea diadema, Pulsatilla, Nux vomica in alternation with Ipec.,
or with Arsen., Conium, Apis, Spigelia and animal food”. (§ 308).
In this comments on the last of
the Hydrogenoid cases reported by him Grauvogl has some pertinent remarks on
Alternations and some further remarks on Nat. sul. which I will quote (II. p.
374) :
”Here is another practical proof
that the dictum to give under no circumstances more than one remedy at a time
is not always applicable.
”Since our Materia Medica
contains, as yet, nothing of this effect of Nat. sulph. (though as a remedy it
is indispensable) I have at the same time given another example that we may
greatly expand and complete the Materia Medica as well as the other doctrines
of Homoeopathy by means of induction.
”If, for instance, the provings
of substances of the outer world on man produce symptoms of disease which are
similar to those which arise from the unintentional introduction of morbid
matter, then these establish the well-known indications according to the law of
similars.
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”But, by this law, however, we
are not taught anything regarding these various molecular substances themselves
and the relation of these molecular substances and their effects on each other,
and on the reaction of the organism. The two are in entirely different domains of
science – o f mind and of matter. These relations can be investigated and
explained only according to the chemico-physical laws within the organism.
”We can explore the
chemico-physical motions and counter-motions which remedies produce in the
organism only by induction, and when we have learned thereby that Nat. sulph.
induction, and when we have learned thereby that Nat. sulph. diminishes the
influence of Hydrogen on the blood, we can only come to the conclusion that the
symptoms of Nat. sulph. must be similar to those morbid symptoms which it can
cure”. (II. 375.)
He goes on to say that the
symptoms removed by Nat. sulph. should be added to the Materia Medica, which
thus can be greatly enriched. This is a dictum which I can confirm from
experience, and which justifies the incorporation of symptoms observed to
disappear under a remedy – clinical symptoms or cured symptoms – as well as
symptoms from direct provings.
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Examples of the hydrogenoid constitution from grauvogl’s practice *
The hydrogenoid constitution
Cases I
Catalepsy, etc. – Nux and Ipec.
in alternation; later Aranea diadema.
A woman, 29, of healthy parents
still living (the father 89, mother 75), has suffered from her youth according
to her statement, on the slightest bodily exertion or mental emotion from
palpitation of the heart. The only cause she could think of was that in her
youth she was very timid and easily frightened, which she ascribed to hearing
children’s tales. Physical examination revealed neither valvular nor other
defects except rapid action even during complete bodily rest; the pulse was 80.
Of children’s diseases she had
had whooping-cough and nothing else. The colour of her skin is brilliant white,
the skin clear, having never presented any eruptions, hair dark-brown, eyes
blue, figure slender, form symmetrical. She had already given birth to three
children without difficulty, but has suffered with an incessant headache since
her last confinement, which was quite normal, and after which she nursed her child
for two months, when she weaned it for lack of milk. All this happened six
years before she came to see me; The headache occupied no definite place but
extended from the forehead over to the occiput, only sometimes it was most
severe on the vertex. This headache did not permit her to visit or receive
visits from her most intimate friends even, because it was so greatly agg. by
talking or hearing others talk that vomiting ensued; and to make the pain at
all endurable she had to take to her bed, where she remained three or four days
motionless and lying on her back;
PAGE 15
Not unfrequently pain in the
stomach set in which ceased of itself after the discharge of sour water rising
in the throat with nausea, and also the eructations of tasteless gas, which was
more frequently induced by the ingestion of vegetable acids or vegetables. Her
appetite was good but not ravenous; she refused to eat meat, even the smell of
it was repugnant to her. The menses, as indeed was indicated by the pain in the
vertex, were irregular, scanty and pale, and were generally six to eight days
too early. In the interval there was more or less leucorrhoea which was
debilitating, and the accession of the menses was announced by a violent colic.
The respiration was
unrestrained, but in the apex of the right lung there was a dull respiratory
murmur, in a small portion without any change of sound on percussion. She never
had any cough and the digestion was regular.
To the above symptoms were
added, since her last confinement also, cataleptic attacks, almost every
morning, after waking from an uninterrupted, good, but not refreshing sleep.
Thus, if her husband did not notice in the morning that she closed her eyes
again shortly after waking, and at the same time sighed once deeply, and at
this very moment did not at once shake her shoulders with both hands and call
to her aloud, then nothing would arouse her from the motionless insensible
condition lasting from one to two hours, in which one could raise her arms and
legs in any direction without them returning to their former position. These
attacks had come and still came and went without any known cause, but they left
behind them no further ailment.
As regards the concomitant
circumstances of these pains, I learned that they were much more violent in
damp weather than in dry and, in fact, her general condition was agg. at such
times, so that this woman, who was previously lively and joyful became more and
more melancholic. The many physicians who had been consulted, the many cures which
had been tried for her, and especially all use of baths, increased her
sufferings. I further learned that her headache especially, even aside from
considering the influence of the weather, was most violent in the afternoon and
evening; that consequently it increased in severity irregularly though
periodically, which also pointed to an affection of the nervous system; that
she constantly suffered from chilliness, hence the whole winter through was
obliged to keep her room very warm, and even in summer she had cold hands and
feet, notwithstanding all her clothing and other means for keeping warm.
PAGE 16
Whoever has read the foregoing
will have no doubt that here we have before us a disease in a hydrogenoid
constitution, which latter must be extirpated first of all, without regard to
the organs affected or the other parts of the organism; for as long as the
general conditions of a disease are not removed no thought can ever be
logically entertained of the cure or improvement of its special form.
I often read in the Homoeopathic
journals clinical cases of physicians whose treatment, contravening this
logical principle, was followed by little good results, or less than that which
really was obtainable; while, by virtue of the Law of Similarity other physicians
again were led to the right indication, though this principle was unknown to
them. This is, then, and involuntary logic of the Homoeopaths, as a counterpart
to the involuntary Homoeopathy of the physiological school.
I know full well that, unhappily,
few Homoeopathists trouble themselves about the physiological significance of
remedies, but in the choice of these remedies they are all the more uncertain
inasmuch as our drug-provings still require complements.
In brief, among all the remedies
which might be indicated according to the law of similarity for the case, which
certainly was not easily to be cured, there were mainly two of which I knew at
once from many years’ practice, that they not only produce a more active
interchange of substance, and hence would occasion more warmth in the body, and
would not only restore the lost power of resistance against the influences of
cold and moisture, but would also have an enlivening effect on the nervous
system. These two are Nux vomica and Ipecac. I have also observed that each of
these remedies had far less effect in these directions when given by itself,
alone, than when they were permitted to operate on the organism in succession.
I therefore ordered Nux 3 to be
taken at 7 or
PAGE 17
Had I sought to conform to this
wish I should surely have had to select quite other remedies, and probably a
long series of them in succession, and most probably too with no favourable
result – or no result at all.
Hence I told the patient that I
could not meet her wishes at once but on the other hand promised her with all
assurance the complete restoration of her health and, within the space of a
year at furthest, a deliverance from all her sufferings; adding that before her
headache could be relieved she would first have to notice a greater sensation
of warmth in her body.
Besides, I forbade her to take
any baths for more than five minutes, and for the time being her accustomed
washing in cold water; and also her remaining near water, especially standing
water. I forbade her also coffee and, of course, vinegar, fruit and fish.
This was on the 1st of May. I
visited the patient every eight days, having told her to take the remedies as
directed for eight days, and then to set them aside for eight days, and so on.
On the 4th of June she stated
that she really thought she was not so cold as she had been for many years, for
she could now even sit in the shade in the garden, a thing which had hitherto
been impossible to her. At the same time the cataleptic attacks had so
diminished in intensity that she had often only a mere intimation of them. But
headache and palpitation of the heart still unfitted her for all occupation.
The cataleptic attacks now
happily had returned but seldom for several weeks (except the merest indication
of them), and even the headaches were no longer aggravated in the evening,
when, at the end of July, her children got measles one after the other. She
would not entrust the care of them to anybody but was unspeakably happy that
she could sustain the bodily exertions and mental excitements thereupon
attendant, which a month before would have been utterly impracticable.
PAGE 18
During the whole course of the
children’s sickness I naturally intermittent the use of the Ipecac. and Nux,
and only gave her Aconite occasionally, as she was very much alarmed at the
condition of one of the children whose disease had become very severe.
After this had all passed off
without injury for the children as well as for the mother, the whole family
went for eight days into the mountains of Bavaria. This agreed very well with
all except the mother; for the took a sail upon a lake, which I had expressly
forbidden, and after this day felt chilly and cold again, the headache also
being notably aggravated.
As I had found in my practice
that Aranea diadema even more than Nux. and Ipec. diminishes the influence of
hydrogen upon the system, and since it was also indicated according to the law
of similars, I directed her to take four or five drops every two hours.
The warmth of the body soon
returned, and for the first time the menses waited for the full four weeks, but
was more abundant and of a red colour. It is a pity that in other cases, the
Aranea diadema produces very violent haemorrhage, especially from the lungs,
which fact calls for caution in the use of this great remedy.
After two weeks the patient
noticed a marked relief of the headaches which had returned; and after eight
days this headache entirely ceased for some days. The cataleptic attacks had
already entirely disappeared for about a fortnight and have not returned since.
But it was not till the 13th of September that the patient finally assured me that,
in the most striking manner, just as if she had been delivered from a bad
habit, she had not had the slightest sensation of a headache for four days.
Nor has it ever returned again
after the lapse of six years.
After another fortnight, during
which time the patient had personally superintended the removal from her summer
residence to the city, a thing which before was not to be thought of, she
called my attention to the fact that after having been in the city three days
she had experienced increased palpitation of the heart again, as had been the
case every year after this change. Now I gave her Puls. 30, since the
constitutional conditions for the previous ailments were all removed. As the
favourable effects of the 30th began to wear off in a few days I gave Puls; 3.
This had the desired effect within six days and the heart’s action became
regular and remained so.
PAGE 19
I now gave her finally Magnes.
sulph. 6, after which even her leucorrhoea diminished, and now disappeared
entirely, not to return.
Thus, at the end of November of
this year this woman was perfectly free from all her sufferings of years’
standing. She went into society again and renewed her youth.
From the above rule and a large
experience I know that neither Puls. nor Magnes. sulph. would have afforded
relief so readily had not the constitutional treatment preceded.
Note on Aranea diadema.
In addition to the already known
symptoms of Aranea and the above quoted symptoms as regards haemorrhages, the
following have been obtained from a proving on a healthy woman :
At night, immediately after
lying down, sudden violent pains in the teeth of the upper and lower jaw.
Periods eight days too early,
too strong and too copious.
Numbness and formication of ring
and little fingers of both hands.
Case II
Hydrogenoid Intermittent. Aranea
diadema.
A pupil of the Academy of Arts,
23, sent for me because he could no longer pursue his art with love and
pleasure; he felt himself so constantly oppressed in the chest that a walk across
the room even put him out of breath; He attributed his trouble to an
intermittent fever acquired in a university city some months before, which was
removed by very large doses of Quinine, of which he often had to take 20 grains
at once. Since that time an enlargement of the spleen had remained which
reached to the space between third and fourth ribs. At that place a dark time
made on the skin with Nitrate of Silver by the professor of the City Hospital
to mark the outlines of the enormous swelling of the spleen was still visible.
Below the first line there were other reddish marks, the traces of similar
outlines which had indicated the gradual swelling and ascent of the spleen. The
heart was pushed to the right and beat feebly, 98 to the minute. The respiration
was very short, raised the right side of the thorax only, 30 times to the
minute, and audible only at the very apex of the right lung.
PAGE 20
The appearance of this young man
of course indicated disease of the spleen. The upper edge was found again
between the third and fourth ribs, though in consequence of earlier
improvement, it must previously have stood lower.
As soon as I entered the house
where he resided and which stood close to the water, I observed that all the
walls were very damp. I was now convinced that I should find a disease-form
arising from a hydrogenoid constitution, for such a house, especially when it
is but little or not at all exposed to the sun, is very sure to harbour
disease-forms of the most varied kinds, but which ought not to be treated
according to their names as they are set down in the text-books of special
Pathology and Therapeutics in which their treatment is struck off after one and
the same model.
Here, however, the disease was a
relapse induced by the damp dwelling. On being questioned the patient said that
he was chilly day and night, although it was midsummer, and as often as it
rained he has always felt worse. He also acknowledged that especially during
the past four weeks, during which time he had lived in this room, he had felt
worse than ever.
On constitutional grounds, as
well as on the strength of the indication of the law of similars, there was no
doubt that the remedy indicated was Aranea diadema. He was ordered it in the
2x, four or five drops in a spoonful of water every two hours.
After eight days the upper
border of the spleen was behind the fifth rib and fell within six weeks to the
seventh. The heart returned to its lace; and in the part of the lung which had
been compressed the respiratory murmur was again distinctly heard, and the
patient felt himself well again. Nevertheless I advised him to continue the
remedy some time longer. Some days after, however, he complained of acute pains
in the teeth of the upper and lower jaws which had occurred for two days when
he retired at night and lasted an hour.
PAGE 21
In this case it was a fortunate
chance that I had already learned this symptom of Aranea from provings. Yet
this case serves again as an example of the diagnosis of the so-called Homoeopathic
aggravation; of a diagnosis which is always justified on the basis of
drug-provings. Not a single adherent of the physiological school possesses that
acquaintance with the effects of his remedies which could explain to him
similar aggravations. Even this important condition for the frequent
elimination of the accidental at the sick-led is utterly unknown to the
physiological school and is one of the causes of a host of mistakes.
The physiological school has
collected some very valuable facts regarding the relations of the water in the
atmosphere to that of the organism, but it does not know of what good they
might be for its Therapy, for it lacks the knowledge of how to find remedies
against diseases arising from a surplus of hydrogen in the organism. Thus
Hemming in his “Doctrine of the Causes of Disease” says :
”The lungs exhale an air
saturated with hydrogen gas of a temperature of 37 ˝° C., 30° R. [99.4°F.]. If
the surrounding air, at a temperature of 37 ˝°C. were saturated with hydrogen
gas, then as much hydrogen gas would be offered to the organism through the
lungs as is given off. But since this is not the case the blood in the lungs
gives off to the dry atmosphere determinate quantities of water.
”Still greater is the
interchange through the skin and the excretion of water by the kidneys. The
exhalation of water through the lungs amounts on the average in 24 hours to
”The mean proportion of water in
the healthy organism is 79 per cent, while there are large numbers of
individuals whose blood contains more water and others whose blood is richer in
solid constituents. The cause of Chlorosis is scanty excretion of water from
the organism, together with a mode of living which allows of the formation of
few solid constituents in the blood. The scanty excretion of water is caused by
living in an air relatively damp, by too little bodily exercise and by
deficient expansion of the lungs.
PAGE 22
”the swelling of the spleen has
developed before the outbreak of the intermittent and is the cause and not the
effect of the febrile attacks; the enormous perspiration produced by the
paroxysm is the attempt of nature to remove the fundamental cause of the watery
character of the blood and the swelling of the spongy body of the spleen
therefrom arising”.
All the above are very good
indications for practice, which Homoeopaths alone know how to make use of.
Could Flemming have found the remedy for this case? Certainly not, since the
Physiological Materia Medica makes no mention of Aranea diadema.
[Commenting on the above case
Dr. Jousset remarked that the “swollen spleen” was possibly a big pleuritic
effusion. But this makes no difference to the fact of the Hydrogenic cure.]
Case III
Sycotic Neuralgia. Natrum sulph.
For many years I have known a
vigorous young man of herculean musculature and form, with most blooming
countenance and cheerful temper. After a few yeas I saw him, quite as powerful
as ever, it is true, but labouring now under mental depression. As I fear
nothing so much as to appear obtrusive, I could not ask him any further
questions, especially as he had assured me in reply to the usual enquiries that
he was very well. A few years later again he came to consult me about certain
attacks which alarmed him very much although he had already consulted on this
account several of the most eminent physicians and had received from them the
same assurance that these attacks had all the less importance as they always
disappeared of themselves very rapidly and completely, in short, that they were
no objects of medical treatment.
PAGE 23
The sun and substance of the
whole complaint was, indeed, trifling enough to the ignorant, and was as
follows : “Within a period of three years it has already happened to me three
times when in perfect health, and the last time three days ago, that when
walking I am suddenly taken with such an acute stitch in the left hip as
utterly disables me from walking further because it is absolutely impossible to
stand on that foot since it becomes so weakened as to be utterly incapable of
furnishing any support. This stitching pain is so severe that I think for the
moment that I shall lose my senses and must fall to the ground every moment;
that I am sure I could not bear it if it lasted but a minute; the pain of
having a tooth drawn being child’s play compared to it, and no words can
describe it. But the strangest thing is that, in the very moment when it seems
as if I must succumb to it, it disappears without leaving a trace just as
suddenly, and apparently just as much without cause, as it came, after having
lasted according to my calculation two or three seconds, and I can at once go
on my way as if nothing had happened. Before and after it I am quite well; but
the dread of never being secure for a moment against this most fearful of all
pains does not allow me to rest till I find help, and indeed I am all the more
disquieted by it as the last time the pain was not only in the hip but at the
same time reached to the knee joint”.
This symptom was already known
to me as a precursor of sycosis in a high state of development, and although
the patient assured me that he had always been quite well, I had him undress
himself and found upon his chest the characteristic exanthem which he made very
light of, since now it mostly broke out in the Spring, now soon disappeared of
itself, while during the whole Summer and Winter it was not to be seen, and he
thought it was to be attributed to the time of year. On further enquiry I
learned that three years ago a friend of his, a physician, had touched some
whitish-blue spots, which he showed him on his lips with Nitrate of Silver,
whereupon after a few days they disappeared and have never re-appeared since.
Moreover, he was often overtaken with such a disgust for life that he had to
summon all his moral force to refrain from shooting himself, though he did not
know any other cause for this than a disheartening disgust for life. Beyond
this I could learn, nothing, and as regards any results from sexual
intercourse, he assured me that he had never observed any whatever. We know
very well how little we can credit such statements. In the meantime it was not
essential to know whether, such a cause had existed or not, for a pathological
form is always the combined result of causes and conditions; hence the specific
disease-form according to time, place and circumstance, is the only object of
Therapeutics. For the sake of curiosity I examined a drop of his blood, which
contained, however, no more colourless corpuscles than is customary in
non-leucoemic blood.
PAGE 24
It has long been known to me
that at the outset of the so-called Sycotic cases the percentage of water of
the blood is increased, as also in the later stages, in which Virchow had
discovered leucoemic blood. It was also known to me that Glauber’s Salts
protected the red corpuscles from the influence of an excess of water, while in
Brüminghausen, Handschuk, Wilhelm, Klurge, etc., I had men before me of great powers
of observation, who were in favour of treating syphilis with Glauber’s Salts,
but who are long ago forgotten, because Sycosis and Syphilis were confound and
there was no indication for Glauber’s Salts in the latter diseases and as a
matter of fact it never accomplished anything. Thus both theoretical and
practical experience sustained me, which left no doubt in me that Glauber’s
Salts were indicated for this case. I did not acquire certainty, however,
except through the Homoeopathic provings of Glauber’s Salts – Natrum
sulphuricum – likewise known to me in so far as this that no other remedy
belonging to this category presents these relations to the hip and knee joints
in connection with other circumstances as do Glauber’s Salts. Without
hesitation I prescribed Nat. sul. 3x, five drops every two hours. Since
prescriptions which are based not only on theoretical and practical experience,
but also on the law of specific direction, or the law of similars, can never
fail of success, so did the result not fail in this case, although it required
nearly a year to complete, and to guard against supersaturating the system the
remedy was often set aside for weeks together. After this period, however,
there was no trace of the exanthem to be seen, the former cheerfulness of the
patient as well as his blooming complexion had returned, and since he has now
passed five years in this desirable condition without further use of the remedy
and without complaints, I may consider the cure to be complete.
PAGE 25
Case IV
Latent Intermittent Simulating
Consumption. Chinin. sulph.
A married woman, 29, suffered
from a cough for eight years without any known causes, the cough having every
year terminated in pulmonary haemorrhage. Four years ago she had for six months
pains in the face on the right side, which would yield to no medical means of
the physiological school, though these pains ceased of themselves after a
change of residence; hereupon, however, the cough, which during the continuance
of the pains had disappeared, returned again, so that the woman became much
emaciated, and had to drink Ems water at her own house since, on account of her
weakness she could not be taken to Ems. By this means, however, her strength
was so far restored that the following year she was able herself to go to Ems
there to continued the cure.
After hour weeks she returned
home no better. Blood was always present in the copious puriform expectoration,
and her physician, who only saw her every week or two, told her husband that
his wife was incurable. She herself, believing what the physician said of her
hopeless condition, became despondent, and her condition sensibly grew worse.
She now thought of consulting
me. Her husband requested me, after telling me everything, and after all hope
of any improvement had long been given up, at least to pay her a visit.
One cannot refuse even such a
somewhat unreasonable demand. I found a woman in a great state of depression,
always weeping, with marked mucous rattle on the right upper part of the chest,
and on the left side as well as the right a clear sound on percussion, puriform
expectoration, constant irritation to cough under the sternum. The menses,
however, were not yet deranged, appetite and sleep were good, pulse 72; the
face was very pale but did not have the expression of the tuberculous. On being
questioned she assured me that she had long ago observed that she had two good
days, and one poor one, and that only in damp weather did she suffer all days
alike; that she had told this to her physician many years before, but he had
always said that it was irrelevant, as well as the circumstance that she always
had cold feet and hands.
PAGE 26
I could now no longer about that
here a latent intermittent had existed for eight years, and the remedy which I
gave, Chinin. sulph., a dose every two hours, had such an effect that, from the
first day the cough became less frequent and on the eighth day had entirely
disappeared. The patient soon appeared very happy and gained in strength from
day to day.
Since then four years have
elapsed and there has never been any return of the cough, or of the
haemorrhage, and the abnormalities on the upper part of the lungs could no
longer be observed.
This woman, granting that I
saved her life, would have been buried long since as surely as the treatment of
her physician of the physiological school was a false one; because these
physicians, on account of the knowledge which they have obtained mechanically,
and of which they always boast as infallible, are not able in such cases to
establish a true diagnosis; for they cannot, and never could, estimate the
circumstances accompanying any disease-form.
Case V
Uterine Fibroma in a
Hydrogenoid. Nux and Ipec.
A married woman, 28, who gave
birth to her last child some years ago without difficulty, and who appeared to
have no predisposition to any disease, complained that for six months her
abdomen had been greatly enlarging to such an extent that everyone had been
congratulating her on a new pregnancy, which, however, could not be the case,
as she had none of the usual indications. Her periods were regular, every four
weeks as usual and only for a few weeks she had had a constant leucorrhoea. The
abdomen was round and everywhere uniformly hard all round in a circumference of
about six inches diameter above the symphysis pubis, but it was entirely free
from pain even on pressure. An examination showed a condition of the os uteri
as in the fourth month of pregnancy. The os was high and directed backwards.
Around it, in the bottom of the vagina, the same cartilaginous resistance was
felt as externally on the abdomen, and this resistance formed the immediate
prolongation of the cervix and thus belonged to the womb. I have twice happened
to observe a similar swelling of the womb arising from a dead fśtus; in one
case the fśtus lay five and in the other eleven months in the uterine cavity
without being expelled. In the first case metritis suddenly set in and during
its course, which could not be mitigated, the separate bones of the fśtus were
discharged one after the other through the rectum. The other case escaped my
further observation. Both cases were free from doubt by means of the signs of
pregnancy which had been manifestly present, and in the latter case even the
parts of the fśtus could be distinctly felt. All this was absent here. Thus it
could only be considered a fibrous polypus, or, more probably, a round fibroid
within the uterus.
PAGE 27
Owing to the size of the growth
an operation was not to be thought of, though to the physiological school any
other resource is unknown. Consequently this woman would have been given over
hopelessly, a prey to all the dangers which were to be anticipated in the case.
What may deliver us from such a
dilemma? Nothing but the teaching of Homoeopathy touching the Concomitant
Circumstances.
This woman did not look at all
ill, had a good appetite and slept well, only she became sooner more wearied by
her domestic duties than was previously the case, in the discharge of which
duties she was very much incommoded by this tumour in her abdomen.
This was on April 4th. The
remedies which I administered internally so long as I had my eye on he object
of the disease alone were attended with no success, and from month to month the
abdomen increased in size until – unhappily it was not till September 6th – I
enquired about the concomitant circumstances. She acknowledged that the felt
chilly every evening, and was worse, that is, there was more rapid enlargement
of the abdomen, during moist weather. On this account I prescribed Nux 3 and
Ipec.
PAGE 28
The improvement continued
without interruption, during frequent suspension of the remedies, and four
years have passed without any complaint from the woman, so that her complete
cure was certainly accomplished.
Case VI
Hydrogenous Pneumonia. Nux and
Ipec.; Nux and Aranea.
A butcher and tavern keeper, 25,
was taken, according to the declaration of his physician, with so violent a
pneumonia that there was no hope of his recovery. The patient, however, was
about to be married and the business would have been lost to his betrothed by
his death. The physician therefore advised the patient to consummate his
marriage as soon as possible. This took place; but now I was called to take
charge of the case, a request which, of course, I thought I had a perfect right
to decline. Yet I could not withstand their repeated urgent appeals for more
than a day. I found hepatisation of the whole right lung from the lowest part
to the apex, above the clavicle, the sound on percussion was somewhat hollow,
and there was some respiratory murmur yet to be heard. The left lung had remained
free from any affection. There was great difficulty of respiration, excessive
debility, voice harsh, inability to lie on the left side without danger of
suffocation, pulse 130. The cough brought up purulent yet scanty expectoration,
the tongue was thickly coated, appetite entirely wanting. There was great
emaciation with collapsed features.
PAGE 29
On enquiry the patient stated
that one day he was better – on the next decidedly worse, and then at 8
p.m. he was worse then ever, so that he
really thought the evening before that his time had come; he felt chilly also,
notwithstanding the constant sweat, and in spite of the warm clothing on his
abdomen. I prescribed Nux vom. and Ipec. in alternation every two hours. On the
next day, August 2nd, there was amelioration of all the symptoms. After eight
days he still was chilly in the upper part of his body hence Aran diadem. 3 was
given in hourly alternation with Nux, although the hepatisation was decreasing
from above downwards more and more every day. On August 29th he was already
able to remain two hours out of bed, for his appetite had returned in the first
days of my treatment, and hearty food was given as his strength increased. He
now felt quite well. The whole right lung was again serviceable for respiration,
and in the same proportion the burden of the other ailment was also removed.
The bodily weakness, however, was still considerable.
That day the young wife of the
patient was standing at the door of house as her previous physician passed by.
He stopped to enquire about her husband, when, with a joyful countenance, she
replied that he was quite well and already up. To this the doctor replied,
“That is utterly impossible”. A week later the patient himself met the doctor
and gave him ocular demonstration of that which he had declared to be utterly
impossible!
Case VII
Caries of Os Calcis; Gangrenous
Ulcer. Arsen., Aggravation by Calc. and Silic., Cure by Aranea diadema.
After opening an abscess on the
left heel of a man, 75, the edges of the wound mortified and the physician
declared that as gangrena senilis had set in the foot must be removed. Upon
this decision I was called in. For more than year I had seen this old man in
the street limping with his left foot, and now I saw clearly the cause thereof
– a chronic inflammation of the periosteum of the os calcis, which had probably
extended to the bone itself, and a gangrenous ulcer half and inch broad,
causing insufferable pains and surrounded and partially covered with a
gangrenous crust. Arsen. 10 gave prompt relief. The gangrenous crust was thrown
off. The surface of the ulcer took on a healthy appearance, but after ten days
did not show the least tendency to cicatrise, although the pains were
decreasing. Both Silic. 10 and Calc. c. 10 aggravated all the symptoms so far
as this that none of them were better, but the ulcer had increased in breath
and depth, so that the probe could now touch the denuded and carious os calcis.
The patient wanted his first drops again because they had relieved his pains,
which now had returned to their former severity. This was granted him in the
absence of any better indication. But he sleeplessness setting in, which could
be attributed only to the Arsen. required that this remedy should again be
discontinued. His sleep now returned but the pain increased again also.
PAGE 30
A thorough examination now led
me to the source of all his troubles, to which, indeed, the striking effect of
Arsen. had already called my attention, as this remedy was given only to arrest
the mortification. On being questioned, the patient acknowledged that his pains
increased and decreased periodically, and that regularly, every other day. He
added that he might have told me this long before had he supposed that any
importance could have been attached to such a trifle. He had thought that quite
as little importance was to be attached to the circumstance that he was always
cold, and hence was always trying to get warm.
Aranea diadema removed the pains
and effected a rapid cure. At first the ulcer grew less; then many very small
sequestra were thrown off; but five months passed under the repeated use of
this remedy before the cure was complete.
Hay-baths
I avail myself of this
opportunity to call attention to the use of hay-baths in many forms of caries
and in enchondroma of the bones. It was in the country that I first learned of
these baths as a popular remedy for necrosis of bone. If what the country
people related to me is true then it can only be the Silex contained in these
baths which makes them useful in diseases of the bones. Hence I examined the
hay chemically in order to learn whether Silex could be found in solution in
these baths; and this proved to be the case.
PAGE 31
Case VIII
Hydrocephalus. Sulphur, Calc.
phos., Arg. nit.
A young married couple had two
years previously lost a child from acute hydrocephalus. The second child, then
eight months old, was committed to my charge when the disease had already
reached the convulsive stage, and it died in a few days.
It now devolved on me, as the
family physician to solve the problem of protecting the next child from this
disease and thus remove the conditions under which, both times, the development
of this fatal disease had been possible, a problem which, as everybody knows, the
physiological school is not able to solve.
Both parents were perfectly
healthy and never ill. Both had blonde hair, thin skin and blue eyes. The
husband was spare, the wife of full habit. Hence no positive point of support
could be gained from either. The wife had nursed both children, but without
having sufficient nourishment for them as I learnt on enquiry, for she was
obliged to give them in addition milk and sugar-water, and both were taken ill
when they began to cut their teeth.
In hydrocephalus the nutrition
of the bones is always deficient and hence during the period of dentition this
nutrition must be carried on at the expense of other tissues. But the
conditions of this deficient nutrition of the osseous system must have given
long before the period of dentition.
Hence I told the wife that she
must not nurse the next child, and that she must during her next pregnancy take
Sulph. 6 one day and Calc. phos. 6 the next, so that she should not lose a
third child by this disease. Sulphur I wished to exhibit as a nutritive remedy
favouring the formation of tissues, while Calc. phos. was to favour that of
bones.
PAGE 32
Five weeks later the woman
informed me that she was again pregnant and asked me for these remedies. She
was delivered at term, and this child, now five years old, remained healthy, as
well as a second, now three, which was carried the regular term under this
prophylactic treatment.
These are not solitary cases,
for I have pursued this method for six years in all families in which there has
ever been a hydrocephalic child, and with the same good result.
But where I have taken charge in
other families of children who had already suffered from hydrocephalus none
died during the last seven years, during which time I have given such children
every morning and evening a powder of the second trituration of Calc. phos.;
and only such children as I first see in the last stage received morning and
evening a few drops of Arg. nit. 6 and every two hours the powder of Calc.
phos. with the best result. t the same time I have repeatedly convinced myself
that in such cases one of the remedies alone affords no such relief.
Case IX
Sycosis. Thuja and Natrum sulph.
In September, 1861, I received
from a well-known Homoeopathic physician the following letter, which I give
verbatim :
”I hope you will excuse me for
taking the liberty of relating my disease to you with the request that you will
kindly give me the benefit of your skill in my case.
”I am 53, of nervous
constitution and have suffered from piles since my youth. I have employed all
sorts of remedies against these with but transient treatment. Subsequently a
hypochondriac mood was super-added. Homoeopathy and the water cure have given
me but little relief from my sufferings. My manner of life from my youth up was
much like that of others. I drank two or three glasses of beer every day,
smoked tobacco and partook of the ordinary fare. Married at 23, I became the
father of eight children, quite healthy and vigorous. I was never syphilitic,
rachitic or scrofulous, but when a child was afflicted with itch which perhaps
was checked too soon by means of ointments. Although I was never excessive in
amorous indulgence, I always observed a pressing pain in the testicles after
coitus, which was more violent a the coitus was more frequent and vice versa;
it was agg. when standing but amel. by walking and still more on lying down.
This, perhaps, may have its cause in youthful sexual sins.
PAGE 33
”My haemorrhoidal pains, which
were especially severe in the years from 30 to 40, tormented me after every
stool with their burning pains as if the parts were raw. Later in life the pain
disappeared, and the haemorrhoidal knobs were only swollen when I drank a glass
of beer too much of an evening. Only very seldom was there any discharge of
blood, and it was only after having used cold sitz-baths and cold injections
for several years that there were repeated haemorrhages after stool, without
affording any essential relief.
”I am very nervous and hence could
never take the sitz-baths under 68° Far., since if used in a lower temperature
febrile attacks were always induced.
”In 1859 an acute burning sore
pain appeared again after every stool as well as protrusion of the
haemorrhoidal tumours. The pain after stool was very severe and sometimes
continued for hours. As no remedy afforded me any relief I determined to adopt
a vegetarian diet. Accordingly from the beginning of September, 1859, I avoided
all animal food, drank no beer, denied myself smoking and every irritant. My
breakfast and supper were bread and milk; my dinner consisted of vegetables and
dishes made of flour and milk; my drink was water. As a consequence i strictly
resisted the greatest longing for meat. Now and then I took a dose of some Homoeopathic
remedy of which Calc. Carb. and Sepia 200 acted most beneficially. In
connection with this I practise gymnastics every day according to Dr. Neumann’s
directions in his ‘Hausgymnastick’. My sufferings were more endurable but the
haemorrhoidal pains continued, and a melancholy as of undeserved injustice set
in, with pressure in the throat, agg. on walking in the open air; easily
wearied by a long walk causing a careless gait. Last spring I became
accidentally acquainted with Braunscheidtismus and got possession of
Braunscheidt’s book. The great recommendations of the method against
haemorrhoids and hypochondria soon aroused a desire in me to try it. Hence I
proceeded at one to carry out my plan and applied the instrument with intervals
of ten days upon the back the sacrum, the whole circumference of the abdomen,
on the outer side of the thigh, on the calves seven times, and it was used the
last time seven weeks ago.
PAGE 34
The result, however, is very
sad; for after the fifth application the left axilla swelled up and became
painful. Soon after I got an ulcer on the outer side of the thigh, and one on
the left forearm, suppurating for a long time. Then developed a reddish knotty
eruption spreading over the whole body. The tubercles of the size of a small
lentil are in many places so elevated above the skin that they resembled
wart-like excrescences. These have their seat chiefly on the vertex, above the
ear, on the forehead, on the left side of the neck, between the scrotum and the
right thigh, and scattered here and there on the penis and about the anus.
Small scales form on them, they itch but little and after being scratched the
itching is relieved. At the same time, above the third rib on the left side
near the sternum there was a swelling, painful on pressure. My knees became
stiff so that I could go upstairs only with the greatest labour. There appeared
besides an oppressive weight on each shoulder, with sensitiveness thereof to
pressure. Great sensitiveness in separate small portions of the thorax agg. by
drawing a deep breath and by eructations, but soon, disappearing again, now
frequently annoyed me very much. The most distressing pain, however, was a
rheumatic, throbbing, tearing pain in the head, which disappeared entirely,
perhaps on the use of Merc. sol., Nux. and Bryonia. In short, after this
Braunscheidtismus, as I think, a rheumatism developed itself, which has lasted
now for about six weeks.
”To give a more exact detail of
my case, I take the liberty of describing my present condition as follows :
”Rheumatic tensive pains on the
left side of the neck. Pressing pain on the shoulder with sensitiveness of the
top of the shoulders to external pressure. Pain as of dislocation in the
shoulders and arms on raising the arms. Painfulness of the bones, especially of
the left hand, so that I can hardly grasp and hold a small weight, a book for
instance. Painfulness of the third rib on the left side on external pressure.
Redness and swelling of the skin over the point of the right elbow. A slight jar
with the hand upon a firm substance produced, some days ago, a dull humming
pain in the hand. Painfulness of the spinous processes of two of the lumbar
vertebrae on pressure (at present one only being painful). Painfulness in the
right elbow joint, and on the upper part of the right arm, especially when
turning the hand outwards. Paralytic weakness (and paralytic pains) of the
legs, especially of the right, with painfulness of the knee-joint on extending
and flexing the leg. When sitting in a chair I can raise the right leg only by
keeping it extended. Raising the leg while the knee is bent is impossible on
account of the pain in the knee-joint. Weakness of the knee-joint when walking
in the room. Sitting down or rising from a sitting posture can only be
accomplished by the most powerful support of the hands. Going up stairs is
impossible. Painfulness of the heels, especially the left, when rising and
afterwards, and when beginning to walk. Redness of the uvula and velum pendulum
palati, with pain in the throat, especially on empty swallowing (this is much
better). A red tubercular eruption about the anus and between the right thigh
and the scrotum, almost like warts raised above the skin, itching but little
and especially at first on the forehead, now on the forehead, now on the vertex
above the ears, on the left side of the neck and on the front of the chest.
Furuncles on the right arm near the axilla. For a few days past slight
oedematous swelling of the feet. Respiration sighing. Pulse 90. Weeping mood;
doubtful of recovery.
PAGE 35
”I must add, however, that my
pulse has always been somewhat accelerated, and that the pains seem to be
seated in the bones and are agg. only by pressure and motion, as well as that
the upper ends of the shin bones, just below the knee-joint, are painful on
being pressed. Sour smelling night-sweat.
”The above symptoms have set in
since the use of the Braunscheidtismus. But in order to give you a closer
insight into my disease I will also give you those symptoms which have annoyed
me for a long time and which are now present :
”Confusion, humming, heaviness
and fullness of the head, glittering before the eyes. Roaring in the ears,
mucous rattling. Heat in the mouth. Bad breath. Appetite and digestion good.
Protrusion of the haemorrhoidal tumours at stool. Burning and soreness at the
anus after stool, agg. on walking and amel. by sitting and lying. Cracking of
the joints; sense of swelling and difficult motion of the fingers, agg. when
walking in the open air and in the morning in bed. Powerlessness of the hands
when writing, which is very difficult for me. Hardness and thickening of the
skin on the ball of the left toe, with pains when walking on the pavement as if
treading on small stones. Easy perspiration; sour-smelling perspiration.
Sensation as if a fibre were torn or snapped off suddenly at the left axilla.
Aching in the testicles after coitus; amel. by sitting, still more by lying
down. Pain in the groin from the pressure of the loins, which annoyed me very
much since the Braunscheidtismus, although I have not worn the truss for
fourteen days (at present relieved).
PAGE 36
”Against this complaint I have
already taken Merc. sol., Nux. vom., Bryonia, Ant. tart., Sulphur and
Colchicum. I have now taken Rhus since September 7th. I have taken two drops of
the 2x, repeated at first every six hours. Now, September 21st, I am taking a
dose only morning and evening. I do not notice any striking result such as I
have often seen in my practice.
”I am father of seven children
yet unprovided for, without means, and the support of my large family depends
entirely upon the earnings of my practice. Hence my situation at present is
truly a sad one and the future looks darker still, since I fear my lower limbs
may yet become paralysed”.
No expert will doubt that for
this disease the physiological school has no name, and since it has none it
hence cannot say what is really present here, and at most could recognise as
special troubles, haemorrhoids, paralysis, etc. To establish a Constitutional
Diagnosis is hence impossible for it, and consequently it could make neither a
rational prescription nor prognosis. Neither could empiricism help in this
case. Was Homoeopathy as helpless as the others?
On the contrary. After I had
received this letter of September 23rd, 1861, and had reflected on it wrote the
patient as follows :
”In your letter you have given
me a very good description of the phenomena which are wont to accompany the
development of Sycosis, whether you have acquired or inherited it. Hence you
will have the goodness without delay to take Thuja 30 morning and evening as
well as Natrum sulph. every third hour – four or five drops of each in a
spoonful of water. At the same time I beg of you not to practise great
abstinence, nor to fast, for no form of sycotic disease can be cured without
good food, without nutrition of the parts which remain healthy. Whether you are
quite curable I would rather leave undecided at present, but in any case you
can be so far restored that you will be able to resume your practice again”.
PAGE 37
Truly this strict diet, which
unhappily many Homoeopathists from great misunderstanding of facts insist upon
even to this day, so that to a sick man actually nothing if left to live upon
but the air, does by no means aid in the spread of Homoeopathy, and indeed it
is thus wantonly deprived of one of the greatest guarantees of its results at
the bedside.
I will now give (1) the symptoms
which led me to this diagnosis; and (2) what induced me to give two remedies in
alternation, an abomination to orthodox homoeopathists.
(1) The following symptoms are
above all characteristic of the sycotic form of this disease; Swelling and
suppuration of the axillary glands, sores on the outer side of the left leg; tubercular
wart-like eruptions on the above mentioned parts of the body; swelling of the
rib on the left side near the sternum; stiffness of the knee, the various
so-called rheumatic pains; redness of the velum palati with painfulness of the
throat on empty swallowing; pains in the loins; cracking of the joints; with
all the symptoms above indicated under the modern. idea of the locomotor ataxy
of Duchenne end Eisenmann.
(2) As regards the remarks, that
according to this diagram Thuja is indicated needs no further discussion for
those who are versed in the Homoeopathic drug-provings. But Thuja, both
according to these provings and experience at the bedside, cannot cure the
tubercular, or, as our colleague expressed it, wart-like eruption; Natrum
sulph., alone can accomplish that. But this tubercular eruption is just the
most dangerous form of this disease. If not removed at once it luxuriantly
develops in many parts of the body, especially on the neck and in the region of
the clavicle, and grows into great clusters which the inexperienced confound
with strumous and other glandular swellings and mistreat, although they occur
in places where there are no glands.
PAGE 38
An evidence of this I find in
many patents who have sought and obtained help from me, not only after the
injurious treatment of the physiological school, but also after unsuccessful
Homoeopathic treatment.
For the sake of brevity I will
only give as much of the correspondence as appertains to the case.
October 16th. “The rheumatic
tensive pain on the left side of the neck, the painfulness of the third left
rib and of the spinous processes of two of the lumbar vertebrae to pressure,
the reddish tubercular eruptions between the scrotum and the thigh of the right
side, the sighing respiration, the tearful mood despairing of cure, the
oedematous swelling of the feet have all disappeared.
”The following symptoms are
relived : the pressing pain in the shoulders, the painfulness of the hand on
grasping and lifting even small objects; the painfulness of the elbow-joint
when strongly flexing it, the paralytic weakness of the leg, in consequence of
which it is somewhat easier to rise from a seat and sit down again; the reddish
tubercular eruptions of the head and neck, and the sensation as if in the right
shoulder a fibre was suddenly torn and jerked loose. Osseous distension of the
left parietal bone along the sagittal suture, with less sensitiveness to
outward pressure, which symptom I forgot to give i my last letter. The abscess
on the right arm near the axilla, which broke once, discharged pus, then
healed, has now disappeared by absorption.
”I must add that in the morning
and during the forenoon the pains in my leg are relieved, and that the swelling
of the knees, especially of the right knee, has disappeared, and that my legs
feel best while lying in bed. As I suffered one evening from a violent burning,
tearing and itching in the painful eruption at the anus, I resorted to the
external use of Thuja by which not only was the pain relieved but the
condylomata were also reduced at least one third.
”I could not for a moment
believe my complaint to be of a sycotic nature, for living twenty-seven years
in happy wedlock I have always led a pure life; it would have been a bare
impossibility for me to have indulged in sexual intercourse with any other
woman.
PAGE 39
”One symptom which I have had
for many years has become aggravated – a creaking of the ankle when stretching
out the foot, so that I am obliged to keep the foot quiet in the joint and have
to lie down, whereupon the pain soon leaves. The roaring in my head and ears,
which has become habitual, is also much aggravated. To this is added a dullness
of the brain which does not, however, interfere with conversation”.
To the question whether he
should continue the former prescription and might drink beer, I replied in the
affirmative.
October .31st. “The tubercular
eruption has, for the most part, disappeared; the condylomata (?) at the anus
are reduced to the merest trace. The painfulness of the metacarpal bones on
flexing the hand has disappeared. The exostosis on the left parietal bone is
much improved, and the pains in the right ankle when stepping have not been
noticed for eight days.
”Present condition. Difficulty
of hearing and roaring in the head and ears; painfulness of both trochanters
and femurs when lying on them. Weakness of the knees as from relaxation of the
ligaments; painful cracking of the right ankle when extending it; pain in the
right heel when stepping on it; painfulness of the shoulders, of the point of
the right elbow and of the right index and ring fingers on pressure; of the
left humerus when bending the arm backward, or when raising or extending it.
Sensation of stiffness and sleepiness of the hand, especially when resting on
the elbow. Pains in the neck when bending the head back. Suppuration of the
left axillary gland which is still somewhat hard. Fourteen days ago this was
the case in the right axilla. Painful glandular knots in the groins and the
anterior surface of the thigh as well as in both sides of the neck. Difficulty
of falling asleep; stools insufficient; apparent inactivity of the rectum when
at stool, with protrusion of the haemorrhoids and burning pains; blood when at
stool; urine often interrupted, also with a double stream as if from stricture.
PAGE 40
”On the whole an improvement n
my condition cannot be denied so that I indulge a hope again that I shall be
able to resume my practice”.
I directed him that if there
were any strictures in the urethra they should be dilated, and that otherwise
he should continue with Thuja and Nat. sulph.
November 10th. “Two days after
sending my letter the pains in the throat, which had previously disappeared,
returned again and light grey ulcers with red edges presented themselves. In my
anxiety I took on my own responsibility in place of Thuja, Lycopod. 200,
several pellets in a humbler of water, a spoonful morning and evening. Nat.
sulph. I have continued to take. It is a great remedy. There is nothing worse for
me than my own treatment. Since yesterday I have taken morning and evening two
drops of Nitr. acid., as the ulcers on the throat seem to be spreading again. I
expect nothing whatever from Thuja. But the symptoms and pains of the leg are
considerably better, as well as those of the upper extremities. My mind is
active, but without application or endurance, and when reading I am dull and
unobservant, yet am in good spirits again.
”Years ago I tried to insert a
bougie into the urethra but had to refrain from too great sensitiveness of the
passage
”I shall await your prescription
and shall take a dose of Nit. ac. 200, if anything”.
I replied : “It would have been
better if you had not taken Nit. ac. and Lycop.; they will do no good. Hold
fast to Thuja and Nat. sul. Whatever may occur, there is no indication whatever
for any other course”.
November 23rd. “To-day can
report a great improvement, for the pains in my bones are reduced to a minimum
: the knee-joints are stronger so that I can rise much more easily from my
seta, and that with the help of one hand only. The pain in the heel is much
relieved, and for many days I have experienced such a sense of comfort that
while lying in bed where I have otherwise been in the habit of reading, I give
myself up entirely to this delightful sense of returning health and do nothing.
”For several days there has been
a feeling of some overwork and inclination to sweat, and after i had taken the
first dose of Nat. sul. yesterday morning I had a pain in the bowels as from
diarrhoea; after the second and third dose there appeared besides trembling and
fermentation in the bowels. My good appetite was entirely gone at noon. Hence
these were effects of Nat. sul., which I have now taken fifty-three days
continuously. Thus for the present I have discontinued the remedy. The next
evening there was heat in my right ear, chilliness, and when out of bed a
shaking chill with increased thirst. Pulse 104. At night slight sweat and good
sleep. Pulse now in the morning 116, otherwise I feel well. The sores in the
throat have not spread. Since I took Thuja again the condylomata have
disappeared to a mere trace. My tongue is coated white; the taste is flat;
dryness and heat in the mouth; disgust for meat; this morning no colic;
eruptions of the forehead and head entirely gone. Since the urethra is no
longer as sensitive as it was I have undertaken its dilatation. The urine
passes more easily and there is but seldom a double stream. The urinary
difficulties are also less. The stricture is situated far back at the entrance
of the urethra into the bladder.
PAGE 41
”Till further orders I shall
suspend the use of Glauber’s Salts (Nat. sul.), but shall continue with the
Thuja, which I last took in the 200th (Jenichen’s)”.
To this I replied : “Since you
are now saturated with the Glauber’s Salts, you should, as a matter of course,
suspend their use for about eight or fourteen days. But I should rather see you
continue with Thuja 30, for the 200th requires to be taken at longer intervals,
otherwise you would have your blood over saturated with it too soon”.
December 24th. “I had already
taken Thuja 200 at longer intervals but returned to the Thuja 30 (four drops)
as soon as I received your letter. However, my regular morning stool soon
became so hard that I took only two drops. In a few days the stools were
easier, but soon after the same difficulties at stool returned again. The stool
occurred now with the greatest effort, and was accompanied with burning sore
pains lasting all day, so I was obliged to cease the use of Thuja entirely, and
even at the risk of your finding fault again, I took Nux vom. 30 several
successive evenings with this result : The stools were passed with more ease,
the protruding haemorrhoids became softer and smaller, and I was no longer
annoyed with pain after stool. After ceasing the use of Thuja for six days I
took it again, but the difficulty at stool returned again at once, so that I
resolved to dispense with it for a longer time.
PAGE 42
”After having discontinued the
Nat. sul. for ten days I took it again, three drops in water every hour. After
taking if three weeks my appetite diminished again, and last evening also I had
a slight chill. I took this to be another indication that I was over-saturated
with Nat. sul., and hence will wait for further directions before I take any
more medicine.
”In other respects I improve
constantly. The pains in my right heel have disappeared entirely, and my legs
are so strong again that to-day I was able to rise from my seat without the
support of my hands. An enlarged gland in the left groin, which I have noticed
for many years, has already diminished very much and become softer, and the
kernels on the thigh also appear to grow smaller. In the urethra I can already
pass a catheter of large size. The stream of urine is stronger and not divided
as before. The eruption on the ears has healed. If I find that I continue to
improve, can I take a short walk out of doors? For four months I have not been
able to leave the room”.
Answer. “There is nothing to be
said against the use of intercurrent remedies if they seem necessarily
indicated, since you now seem to have lost the hasty anxiety which sometimes
leads to things superfluous.
”I now commit to you the further
treatment of the case and see no reason why you should not go out in mild
weather, if you only guard against too rapid change of temperature”.
April 12th. “My disease is so
much improved already that I am able to visit patients even several hours
distant, and can go up stairs though with some effort. The tubercles are
somewhat diminished, the bloody stools as well as the condylomata above the
anus have disappeared.
”I have not had any more
occasion for intercurrent remedies Thuja and Nat. sul. I still use according to
your directions”.
PAGE 43
June 23rd. I received another
letter from this colleague asking my advice about one of his patients, with the
remark that he was entirely well and could take quite long walks without
injury.
[Many years ago, Dr. Pascal of
Paris, gave an account of Grauvogl’s constitutions in the Bulletin de
l’Homoeopathie and he added to Grauvogl’s cases the following which he
translated from the Italian Revista Omiopatica – J.H. C.]
Dr. giovanni urbanetti’s case
Hydrogenoid Constitution. Nux,
Ipec., Nat. sul.
M.N. , 46, tall and well built,
having come to Venice with his family in July, 1874, to take the baths, came to
consult me and gave me the following account of his case :
”Although my constitution, as
you perceive, is neither weak nor delicate, I cannot say I am satisfied with my
health. I have never had serous illnesses but I am subject to a crowd of little
discomforts which rob me of gaiety, activity and spring, I am very often
tormented with coryzas which easily spread to the throat and cause a little
difficulty in swallowing, thickening of the voice and bronchial catarrh. I am
worried with rheumatic pains though not severe. My digestion is capricious,
sometimes good, sometimes bad with bad taste in the mouth. I am worse in Winter
when the weather is cloudy and when it rains. I am always very chilly and my
feet are constantly rather cold. I am better in Summer, and especially when I
perspire I feel relived; and if by misfortune the sweat is checked I am easily
taken with slight shivers and quickly fall back into my usual state of
depression. My urine is abundant and the colour varies according as my
sufferings are more or less attenuated. I cannot name any likely cause for this
state, since my life is very regular, I have never had any suspect maladies,
nor has my morale had to undergo any violent troubles. The Homoeopathic
remedies which I take or have prescribed for me, promptly relieve me, it is
true, but they do not protect me against frequent and extremely easy relapse. I
should like to know from you, sir, if there is any means of establishing my
health by any radical treatment whatever”.
PAGE 44
To anyone who knows the
Constitutions of Grauvogl I imagine it would be impossible to find a more exact
picture of the Hydrogenoid Constitution than this. After the directions of the
author the indications for the correction of this form of constitution would be
:
First, to restore the spent
animal heat; then, to disburden the blood of the excess of hydrogen. The first
result was obtained by exciting the spinal nervous system by Nux, and the great
sympathetic by Ipecac. These two remedies should be given alternately, in a low
dilution, frequently through the day and kept up until the bodily heat is
restored. The first effect gained, Nat. sul; 6, two drops night and morning for
a long time to free the organism from the excess of hydrogen, which is the
cause of the catarrhs and rheumatism.
After having well studied the
symptom picture of this case the choice of these remedies was clearly justified
by the law of similars, a guide of which Homoeopaths must never lose sight,
just a she should never forget the special action of the remedies in high and
low dilution, which constitutes a great difference. According to Grauvogl, the
low dilutions act more particularly on the organs, tissues and systems
affected, whilst the high ones act by preference on the general symptoms.
This is the plan I prescribed
for my patient, who promised to follow it out exactly.
In July of the following year he
came to see me again and told me the result of the treatment had been very
happy. He had passed an exceedingly severe winter in Paris without experiencing
any inconvenience.
PAGE 45
Examples of the hydrogenoid sycotic constitution from the practice of dr.
bojanus
The hydrogenoid sycotic constitution
The North American Journal of
Homoeopathy of August and following months, 1888, published a series of case
treated by Dr. Bojanus of Moscow, and published in a German journal. The
articles were translated from the German by Dr. T.M. Strong.
The first eight of Dr. Bojanus’
cases I have somewhat condensed from his narrative. The rest are given in his
own words and are written in the first person. The opening of his article runs
as follows :
”If in reference to the various
constitutions I give preference to the Hydrogenoid, which I shall endeavour to
illustrate by examples, I do this chiefly, first, since this constitutions for
many years past is the predominant one and affords me more material for illustration,
and secondly, because it gives practical proof of what Grauvogl says in his
posthumous work concerning the subject. May it encourage the study of the works
of this eminent and well-deserving enquirer!
“Ever since I began to apply the
study of the doctrine of constitutions to practice, and with eminent success –
twenty years ago – only one single case of perfect Oxygenoid Constitution has
come to my observation.
”The Carbo-nitrogenoid indeed
often appears together with the Hydrogenoid, but seldom alone, and presents in
this fashion an extremely difficult, often enigmatically mixed up, therapeutic
subject. Almost all of the cases mentioned here belong to the period of time
previous to my acquaintance with the posthumous work of Grauvogl; the practical
results, of which but a small portion is communicated here, are based chiefly
on the study of Grauvogl’s Text-book and familiar remarks which I have gathered
during my acquaintance and conversation with him”.
PAGE 46
Dr. Bojanus’ remarks on the frequent
combination and complication of the Hydrogenoid and Carbo-nitrogenoid
Constitutions I can fully corroborate, but for all that, the three-fold
division can be of great assistance in the selection of remedies. Bojanus
endorses what Grauvogl says about the accessory circumstances characterising
the constitutions, but the “Constitution” itself is not sufficiently clearly
characterised in its exterior manifestations to admit of an exact description
of it; “But in reference to the various materials constituting the diet it will
be found invariably that aquatic plants and animals, fruits and vegetables
largely containing aqueous material – cucumbers, melons, mushrooms , moreover,
milk in every form, eggs even cooked soft; as also a moist atmosphere, humidity
in dwelling apartments, even accidental and transitory baths, warm or cold,
drinks of water or of liquids containing much water; rain cold, storms, whose
approach many persons of this sort feel and foretell in advance, not only may
aggravate the disease (in a Nitrogenoid the reverse takes place – at the
approach of and during the tempest they feel better), but may also cause a
relapse after a disappearance of several months.
”After a complete cure even, the
diet restriction should be followed for a further year at least. Among patients
of this class some will be able to digest some of the forbidden articles and
not others without detriment to their health. Some can take salt-water fish and
not fresh-water fish. Some can take eggs and milk but no fish. Most are
decidedly avers to flesh meat”.
Bojanus gives a very graphic
description of the terribly unhygienic condition of Moscow and its two rivers
in his day, which mightily fostered the hydrogenoid state in the inhabitants.
Filth and ice in winter, dust in summer, floods in spring, and smells al the
year round are about the sum of his description. It is not to be wondered at
that intermittents are among the endemic diseases he had to treat, and
“intermittent fever” and “hydrogenoid constitution” are frequently more or less
identical.
I will now give a brief account
of Bojanus’ cases :
PAGE 47
Case I
Insanity with Intermittent
Fever. Veratrum and Arsenicum.
O.K. ,
In July, 1875, she left Moscow
and went to her father’s house twelve miles in the country. At the time Bojanus
was called in, August 6th, symptoms of insanity appeared and soon intermittent
fever, two paroxysms a day,
Then followed a relapse brought
on by the use of water. During this day, November 14th, she ordered the floor
of her room to be scrubbed and as it was not oiled it retained water enough to
keep it moist for a long while. Without any apprehension of evil she spent a
part of the day and the whole night in that room. At 11 p.m. on the following day she began to complain of
headache and pains in the left hypochondrium. There returned also chilliness,
weeping, outbursts of temper with terrible excitement and despair about her
condition with desire for a speedy death. Verat. and Arsen. were immediately
given in hourly alternation. The next paroxysm appeared at the same hour but
was very light, with some sensation of chilliness but without any other
inconvenience, and after the 18th all trouble had ceased.
PAGE 48
Case II
Intermittent fever in the form
of Congestion of the Brain. Atropine and Nat. sulph., later Nux and Ipec.
Z.B. , 6, of cheerful
disposition, having had no severe illness, was taken ill
The following year she had
scarlet fever in a mild form. All went well till during the desquamation period
fever set in. She did not complain of her head or stomach. Thirst increased,
sleepless, and when she did sleep muttered and seemed restless. Was constipated
and feverish. Acon. alone and later Bellad. were without effect. Then careful
observations showed that there were intermissions and Bojanus concluded that it
was the old intermittent that he had to deal with. Arsen. every three hours was
given, water was forbidden as drink unless mixed with wine. From this time the
fever diminished and in ten days she as well, but Arsen. was continued at
increased intervals until the twenty-first day.
PAGE 49
After this Z.B. had good health for several months when it
was noticed that she had a short but continual cough while sleeping. It lasted
several nights but ceased between 4 and
Case III
Intermittent in the form of
Meningitis. Atropine 6x and Nat. sulph.
Adele W., 10, tall, slender,
pale, hollow-chested, delicate, was out walking one clear day in March, 1881,
and on returning home suddenly complained of being sick. Her symptoms were :
raging headache, severe chill followed by intense heat, intolerance of light,
very nervous, nausea, vomiting first food then bile. The following night very
restless, dozed a little but on awaking always had headache, at times slightly
delirious.
Next morning she was very
feverish, high temperature, raging headache, loud singing noise in ears,
convulsive twitching of muscles of face, especially about mouth and cheeks,
very sensitive to touch and irritated by the least noise.
Bellad. 3x was given every hour.
Next day no change. The day after, March 4th, much better. Bellad. was
continued and hydrogenous diet ordered. On March 7th she was taken with severe
chills which lasted fully three days; It was now clear that it was a question
of an intermittent. Atrop. sul. 3x and Nat. sul. 2x, of each three drops was
given on wafers, the body to be rubbed with spirits, and water only to be drunk
mixed with wine. On March 14th she had another paroxysm in a light form and on
the 21st another still lighter. From that time she began to recover her health
and appetite and grew stout.
In March, 1882, one night she went
to bed well and woke up in a few hours screaming with pain in right ear, cheeks
flushed, more on right side. Atrop. 6x Next two days she was free from pain but
on the fourth day she had another attack but less severe. Atrop. 6x, and Nat.
sul. 2x every hour. There were four more attacks, all quartan and each time
shorter and lighter. She was seen last in the winter of 1884 when she was well
and had been so since the last attack.
PAGE 50
Case IV
Intermittent Fever in the form
of Lepto-meningitis. Nux and Belladonna, Nat. sul. and Nux. (I give this case
in Bojanus’ own words. J.H. C.)
In January,
I learned from the father that
his daughter was three years old, had been ill six weeks, and the doctors had
told him his daughter was suffering from inflammatory hydrocephalus. I remember
having then made the remark that there must be an error somewhere, for from my
experience, and from what I had read, I had never heard of so protracted a case
of lepto-meningitis. When I arrived at midnight I found the child lying on her right
side, her face turned to the wall and her right hand resting under her cheek;
her legs were crossed; she was asleep but eyes partly open; she was very thin
and pale; her skin not warm, but normal; she was breathing easily; pulse,
80-90, not hard; would cry at the least touch. I found between the two
shoulder-blades a blister the size of the hand due to a vesicant. This I
immediately opened and applied a cerate dressing.
While I was going this she
cried, but showed no other abnormal signs. She was very much constipated. With
the best of good will I could not find out how those physicians made such a
diagnosis. The intelligent nurse said it was but natural I should think so as I
had not seen her when she had her spells, but if I would take the trouble to
call the next morning about eight o’clock I should probably agree with them. On
further questioning the nurse she told me that the child’s mother, who was till
a young woman and nursing her youngest child, through sorrow and trouble had
nearly lost her mind.
PAGE 51
At first the child’s sickness
attacked her in spells, but each day she became worse; to-day she had a quiet
one, but to-morrow, at the same time, would become worse; her sickness would
begin with cold hands and feet and headache, vomiting of bilious matter,
squinting and rolling her eyes, with convulsive motions of the face and
occasionally of the extremities. This would last for three hours, then she
would become more quiet, and by the afternoon and during the next day would be
in her usual health.
I now examined the liver and
spleen, and found the left lobe of the liver enlarged to the extent of one and
a half finger-breadths, and the spleen to an equal if not greater extent;
chalk-white stool (similar to what might occur form an exclusive milk diet)
without any icteric taint. Urine dark and without sediment; appetite poor and
only on the well days; lived almost exclusively on milk which she also took to
satisfy her thirst.
I informed the parents that
under the circumstances I might not be able to group properly all the
conditions, but no time should be lost on this account, since everything
pointed to one conclusion, that we were not dealing with an acute
hydrocephalus. On the next morning at 7 o’clock I went to see the child in order
to see the symptoms reported by the parents. A few minutes before eight o’clock
the hands and feet became cold, followed by pale face, headache and weeping,
the latter occasionally interrupted by a shrill cry. Twice there was a slight
vomiting of bilious matter. After this condition had lasted over one hour the
cheeks began to redden, the temperature increased to 39.3 c, pulse 100 to 120,
occasionally intermittent, generally full, eyes distorted, twitching in the
face with drawing of the mouth as if in laughter, pupils contracted,
respiration quickened, intelligence lessened, slight convulsive movement of the
left side. Half an hour later the child began to bore the head into the pillow,
while there was at the same time a convergent squint. There was no more
vomiting, but at intervals a shrill cry. The paroxysm lasted until
PAGE 52
To compel obedience to these
rules was very difficult, since there was but one opinion under the
circumstances, namely, that the case was a most desperate if not hopeless one.
After many unsuccessful remonstrances I finally said that since the child had
been given up by the physicians we could only try, and that I could not permit
any other treatment than the one ordered and if no permitted to carry it out
unrestricted I would cease attendance.
This had the desired effect, the
nurse obeyed my orders accurately. I gave the child an injection of warm water
to relieve the constipation.
I called about eight o’clock the
next morning, thinking she would have another spell, which attacked her at nine
o’clock, but in the same way, namely, with cold hands and feet, and she begged
to have more covering over her (which she had not asked for before).
She also had a severe headache,
but did not scream. Soon after she became feverish, with a temperature of 38.5
c, pulse 80 to 85. She was not delirious and had no convulsive movements of
face or extremities. She then fell asleep until 10 o’clock, and perspired
freely which she had not done before. she awakened about one o’clock, was very
weak and indifferent. Soon followed a pale, grass-green stool. The three
following paroxysms, still of the tertian type, did not differ in intensity or
duration, except that the perspiration was decidedly less. Apparently there was
a change in the condition. Since improvement went on slowly, and the lessened
perspiration seemed to threaten a relapse, in place of the Belladonna I gave
Natrum sulphuricum 2x in alternation with the Nux. 3x, every two hours. After this
she had two paroxysms accompanied by profuse perspiration. The second, however,
was light, and after this the child began to recover; appetite and sleep
improved and by continuing the use of the remedies, but not so often, until the
twenty-eighth day after having the last paroxysm, and with a strict diet, in
three weeks she was able to leave her bed and walk about.
PAGE 53
In 1876 I saw her for the last
time. She was then in good health and I have not heard from her since.
In 1876 I saw her for the last
time. She was then in good health and I have not heard from the since;
An interesting part of this case
is that when the child was able to go about the father met Prof. F. in the
street, when the Professor inquired after the child. On being told that she was
well, he threw up his hands above his head and exclaimed, “That is impossible!”
“Come and see her and satisfy yourself”, replied the father. But he did not
come.
Case V
Neuralgia, Chill, Night-cough.
Nux. and Arsenicum, Nux. and Ipecac.
Frau E. von E., a slender
delicate woman of good constitution, who celebrated her eightieth birthday
during her illness, complained in December, 1863, of pain in the left side of
the face, especially in the zygoma, the pain being of a tearing, drawing nature.
The corner of the mouth was slightly drawn to the left, and there was twitching
of the lower eyelid. There were marked remissions and occasional intermissions
which were very irregular. There was no periodicity noticed. The pain was
markedly agg. at night. In other respects the patient was perfectly well and
actively busy with her usual duties. Spigelia 12, three drops every two hours,
was prescribed, and the pain gradually disappeared, only the twitching of the
lower eyelid remaining. Causticum was now given night and morning, and a few
days later the twitching was gone.
But this was succeeded by a
severe chill lasting the entire day and followed in the evening by high fever
which continued the whole night. This produced complete loss of appetite, but
did not affect the general health and she continued at work as before.
Causticum was continued, but as there was no change at the end of a week, a
wine diet and rubbing the body with brandy were ordered and Nux. 3x and Arsen.
3x were given every two hours alternately.
PAGE 54
At the end of a week the
feverish condition had lessened, but a night cough, entirely relieved by day,
now came on. Otherwise her condition remained the same except that her appetite
was better. The loss of sleep weakened her and although she got some sleep in
the day it did not make up for that lost in the night. Nux. 3x and Ipecac. 3x
were now given every two hours alternately. In a few days the cough
disappeared, the sleep returned and the patient seemed well. Several weeks
later when Bojanus again called she told him that after the cough left she had
been weak and then noticed a swelling in the back of the feet which had
increased slowly till it reached the knees. She complained only of difficulty
in walking and itching of the swollen extremities and was otherwise well. There
was a trace of albumen in the urine but no casts, and liver and spleen were
normal. Bojanus ordered a half lemon to be taken night and morning with plenty
of sugar but no water. at the end of a week the oedema was gone and the patient
was not again ill till she died of old age at 88.
Case VI
Intermittent Fever under the
form of Prosopalgia. Nux and Ipec., later Aranea.
D.B. , wife of a Russian
clergyman, 36, small of stature, emaciated and badly nourished, mother of
several children, consulted Bojanus on March 6th, 1878, complaining of pain in
the left side of the face, which as of long duration and came on every day at 2
p.m. It followed the three branches of
the trigeminus, and she also complained of a persistent chilliness not relieved
by the heat of the sun or a warm room. This had lasted two years, the pain in
the face having first appeared in March, 1877, and had proved intractable to
all kinds of household remedies and was only removed by Quinine given under
medical advice. But the general health was not improved, and in the beginning
of autumn the pain returned and though again relieved by Quinine the relief was
slower in coming than at first. She now gave this history :
PAGE 55
With the onset of chilliness,
with cold hands and feet, there appears a burning pain deep in behind the joint
of the lower jaw. The pain radiates into the eye causing weeping, into the
eyelids, the left side of the nose, the cheek and all the teeth, upper and
lower and even to the chin and lips. To this pain there is added a particularly
painful, intermittent tearing sensation from within outwards. The only relief
was by the application of very hot dry cloths. After the attack had lasted
about two hours the pains began to slowly lessen, the entire attack lasting
from three to three and a half hours, after which she felt very weak and faint.
Fever and sweating were absent during the attack. She complained of want of
appetite, the tongue was coated white with insipid taste, and there was
aversion to meat; long continued sensations of coldness or chilliness over the
whole body and constant coldness of the hands and feet. The liver and spleen
were normal, menses regular and scanty but without pain, no constipation or
thirst. Nux 3x and Ipec. 3x were given every hour in alternation during the
pains. The usual diet and wine were ordered and no water except mixed with
wine. On March 17th she reported that after three days the pains began to
disappear gradually and for three days there had not been any, but the
chilliness and cold hands and feet remained. On April 26th, the pain had not
returned and the chilliness and cold hands were better, as also the general
health.
The Medicines were continued at
longer intervals with strict instructions that the diet should be continued for
at least one year. On March 28th, 1879, the patient reported that the pains had
returned one week before. Since April 1878, she had taken the medicines as
ordered, for two weeks four times daily, in alternation, for two weeks twice
and for a further two weeks once a day. But she had not been strict with the
diet, especially in the latter part of the time. Nevertheless, she had been in
good health until the beginning of the great fast (Lent). (According to the laws
of the Russian Church the seven weeks of the fast are very strictly kept.
Nothing but vegetable food is allowed; only on two days of this long fast can
fish be eaten, namely, at the feast of the Annunciation and Palm Sunday. The
diet consists of cabbages, turnips, potatoes, mushrooms and farinaceous foods,
everything being prepared with oil; animal food is strictly excluded).
Believing that she was quite well she began to fast and at first suffered no
inconvenience, but on March 25th she could not resist the desire for fish and
on the 26th the neuralgia returned, together with the coldness of the hands and
feet. It also transpired that since the winter she had been living in a very
damp house. Aranea 3x and Spigelia 3x were given in hourly alternation.
PAGE 56
On April 12th the pains had been
entirely absent for three days and the patient felt decidedly better. The
remedies were continued and it was directed that for twenty-eight days after
the least attack the diet should be strictly observed and a drier dwelling
found. Seen by Bojanus when attending her children during 1882 to 1884 there
had been no return of the trouble.
Case VII
Intermittent Fever under the
form of Pneumonia. Ipecac. and Nux.
B.T. ,
PAGE 57
Examination showed that there
was no fever. The tongue was slightly coated and there had been no stool since
the day before. Percussion gave negative results. There were fine bubbling
rales under the left scapula; when quiet there was no cough, but it at once
appeared when moving about. Bojanus diagnosed bronchitis or catarrhal pneumonia
with a malarial complication and warned the parents that they might expect
another paroxysm. Ipec. 3x, in two-drop doses, was given every hour.
The next paroxysm came on at 10
p.m. , and was ushered in with a severe chill, which lasted one hour, and great
thirst; the cough quickly followed and was accompanied with headache an general
pain, together with restless tossing about the bed. A few minutes after eleven
the fever began with reddened cheeks, increased heart-action and a temperature
of 39.3 to 39.9 c. There was quicker respiration, violent action of the
nostrils, drawing in of the lower ribs, aggravation of the cough, increased
restlessness, crying and tossing around, all continuing until half-past twelve.
The thirst was not so great during the fever. The child became easier as the
sweating stage began, which was this time more copious and of shorter duration
than in the previous attacks, the whole paroxysm being lighter, as the mother
said, than the former ones.
Nux. 3x and Ipec. 3x were given
in hourly alternations during the interval, together with wine diet and rubbing
morning and evening with brandy. The three following paroxysms were each
lighter in character and after the last the child began to improve rapidly.
During the Spring and early Summer he was well and before the hot weather was
removed to a drier dwelling and then into the country, so that he suffered
neither a relapse nor a new attack. Seen in 1884, then fourteen years old, he
was in rugged health and had had no other sickness.
PAGE 58
Case VIII
Intermittent Fever under the form
of Pleurisy. Nux. and Ipec.; Ipec. and Aranea.
M.D. , 46, mother of a grown-up
daughter, had suffered for many years on each recurring spring with the
following conditions :
Early in March, without any
visible cause, she would be attacked with a severe sticking pain in the left
side of the chest which interfered with the respiration and with this there was
a chilly feeling lasting and hour, followed by fever lasting three hours,
during which the pains were aggravated, the breathing more difficult, and
accompanied with a cough, generally without expectoration, but sometimes there
was a frothy, slimy sputum. There was also intense thirst, dryness of the
mouth, headache and internal chilliness but with hot skin with desire to be
covered during this period and sometimes longer, sometimes shorter but never of
over three hours duration. This was followed by profuse sweating lasting
generally from two to two and a half hours, during which the pains lessened,
the breathing became freer and the cough looser. On the following day the
patient was able to be up for a few hours, but this only lasted two days when
the attack recurred. This state of things lasted till May, when every symptom
disappeared and she gradually recovered her health.
the usual treatment gave no
relief. The only benefit she got was from Quinine, but latterly she had been
compelled to take such large doses that they caused a feeling of apprehension
and giddiness. Bojanus found the general condition on the whole discouraging;
appetite poor, cannot take milk which causes diarrhoea, nor fish, which causes
pain in the stomach and nausea; she does not care for uncooked fruit and has an
aversion to meat, so that, as she expressed it, eating is a matter of
indifference. She was emaciated, often compelled to resort to wine, spoke
slowly and in measured tones, always felt weak and exhausted. The tongue was
slightly coated, no constipation, sleep generally light, disinclination to
motion and work which she ascribed to her weakness.
PAGE 59
In March, 1876, and examination,
Bojanus writes, showed the following : “Liver normal, spleen slightly sensitive
to pressure. Percussion gave negative results, while auscultation showed, with
normal respiration, at the sixth inter-costal space on the left and backwards a
distinctly audible friction sound, so distinct, indeed, that I was not certain
of its cause. This much was certain, that we had to deal with a quartan type of
intermittent fever. Nux 3x and Ipec. 3x, three drops of each were given in
hourly alternation together with a wine diet and rubbing of the whole body with
alcohol three times daily. At the next attack all the symptoms returned and I
heard during the fever paroxysm the friction sound under the before-mentioned
painful spot. For this I ordered a compress to be applied during the fever,
removing it when the sweating stage came on. After four successive lessening
attacks the fifth failed to appear and the patient began to improve. The
appetite increased, also the general strength and she became more active and in
better spirits. Auscultation showed steady vesicular respiration and complete
absence of the friction sound. A few weeks later the patient went to the
country with instructions to continue the medicine and closely follow the diet.
”During the following winter she
enjoyed good health but in the early part of April I was again called to see
her, and learnt that the attacks had returned, but in a tertian form, although
she could not remember any error of diet and the attacks were somewhat different;
she has now constant chilliness, the fever and pain in the side were less and
the paroxysms did not last as long. I again examined during the paroxysm,
percussion gave no results and I heard on auscultation, distinct normal
respiration and a very slight friction sound. She now received Ipec. 3x and
Aranea 3x in hourly doses, together with the same diet and rubbing with spirit.
The second attack was so slight that she had no desire to remain in bed, and
there was no other. In 1880 I saw the patient for the last time, and she had
had no sickness up to that time.
[The remaining cases are given
in Bojanus’ own words.]
PAGE 60
Cases IX
Intermittent in the form of
Pleurisy. Nux and Ipec.
This cases, very similar to the
last, says Bojanus, came to to me in 1872.
The five-year-old son of General
R. had been treated for two weeks by an old-school physician but without
benefit. When I saw the child for the first time, a plaster, leaving a blister,
had been removed from the affected side so that percussion and auscultation
were not to be thought of in this capricious, spoiled and fear-inspired boy,
who at the approach of every stranger uttered a terrified cry. I learned from
the mother that two weeks before, without any apparent cause, he as attacked by
a chill, not long in duration, followed by fever. With the chill he began to
cough and with each coughing spell distorted the face and cried. He also
complained of pain in the left side, more towards the back. The physician was
called and said that the trouble was pleurisy, which was evident enough, and
ordered a mixture which was given at once. Soon after this, sweating began and
he rested easier, and towards evening of the same day the disease had
apparently disappeared, which was naturally ascribed to the mixture. On the
next day the boy seemed relatively well and was running round the room since it
was impossible to keep him in bed. On the following day the same scene was
repeated and so continued until the boy refused to take the medicine and it was
not possible to use force. The mixture contained Quinine. Up to the time of
consulting me the attacks had been of the tertian type. I could not examine nor
question the boy, but from his well-nourished and vigorous appearance, and from
my own experience, the scrofulous basis was plainly manifest. I gave Nux 3x and
Ipec. 3x in hourly doses, and ordered a wine diet, to which the other at first
objected. During the following week there were paroxysms of which the third and
last was very light, and the boy was soon well. He now permitted a careful
examination, but it was without result. For three or four years after this I
have seen the boy and during that time there has been no relapse.
PAGE 61
Case X
Long-continued Intermittent
Fever, simulating Tuberculosis. Phos., Kali nit., Nux and Arsen.
A young man, 20, of whose family
I had been physician for many years, had suffered greatly from intermittent
fever the last two years while residing in Dorpat, where he was attending the
gymnasium and, as his parents would not employ old school treatment, he was
prescribed for by letter, and each time relieved, but from want of perseverance
with the diet, and on account of the climatic influence, he was constantly
subject to relapses.
In February, 1882, this tall,
but reasonably strong young man, of good constitution, again fell sick. When a
child he had had scarlatina of rather severe form with albuminuria. Later he
had measles but no other diseases, except the above-mentioned intermittent
fever which frequently relapsed notwithstanding the use of Nux, Arsen., Chinin.
arsenicosum and Natrum mur. As he was preparing for his graduation examination
he could not return home but as compelled to remain at Dorpat until the end of
May. His elder brother was at the same time a student of medicine in Dorpat and
could do nothing but call upon Professor Vľ, who proceeded to treat him,
secundum artem, with large doses of Quinine and stopped the paroxysm, but as it
persisted in returning, larger doses of the drug were used. So matters went on
until he had passed the examination and was about to attempt the matriculant’s
examination for the university.
At this time he was seized with
a general feeling of exhaustion and an irritating dry cough which alarmed his
brother, and Professor Vľ was again called. He made a careful examination and
found dullness with abnormal respiration at the left apex and ordered the
patient to seek a warm southern climate.
Daily towards evening there was
fever with copious night-sweats, and in the face of Professor Vľ’s opinion
already expressed, the brother asked him what he feared. “Dear friend”, said
the Professor, “here is a serious matter; do you not see tat tuberculosis and
hectic are in union? I have seen a mass of such patients; I am not mistaken”.
PAGE 62
The young man was startled and
could not believe the words, although they were those of a master, and so
called in Dr. Sľ, who, after seeing the patient, gave, if not in the same
words, at least the same sentiment, and thus the correctness of the diagnosis
was established.
The brother now wrote home
describing in extenso the condition of patient, as also the result of the
physical examination, whereby it became apparent that the fever recurred every
evening with slight chill, general heat, and a copious sweating, thus
simulating hectic fever. I wrote to Dorpat inquiring if the professors thought
the condition of the lungs to be a result or cause of the fever, since, if they
determined that this was the cause of the fever, then the changes in the lungs
must have preceded and not followed the fever, and this the more since it was
known to me that these same gentleman had examined this patient at other times
and pronounced the lungs to be in good condition. I was also anxious to have
this question answered since they had decided not only in this but in other
similar cases, that a rational therapeutic treatment was not possible.
the answer returned was that the
fever was a hectic fever and was dependent on a commencing disease in the lung.
I saw that my question had not been understood and urged the patient to come to
Moscow, which he did. On his arrival I examined him most carefully but could
discover no dullness although the abnormal breathing was noticeable. I also
learned that for the past three years, in each succeeding Spring, he head
suffered from intermittent fever, and during the present season the same, and
as it did not seem to yield to the medicines which I had sent, large doses of
Quinine had been taken up to ten-grain doses. Still the fever returned until
finally the attack came on each evening with chill, heat, headache, weakness,
despondency, ill-humour, restlessness and dry cough. These conditions were also
present, in a lessened degree, during the apyrexia. The young man had grown thin,
there was loss of appetite, the sleep was disturbed on account of the fever and
night sweats, and was only and unrefreshing slumber, while the normal condition
was very much disturbed. I ordered Phos. 3x and Kali nit. 3x hourly in
alternation with the wine diet and rubbing the body with spirits. At the end of
three weeks, under the continuous use of these two remedies, the fever and
abnormal breathing had entirely disappeared, while the appetite had improved
and the patient was cheerful and bright.
PAGE 63
In order to quiet the family,
and also on hygienic considerations, I advised the young man to seek another
climate, and, in order to lose no time, to begin his studies in South Germany,
which was done. In the meantime, his brother who had attained his degree,
travelled through Austria in October of the same year and was a witness of his
good health and activity in his studies.
In the Spring of 1883 the former
wrote me that his brother had had a threatening of a return of the fever but
that Nux and Arsen. promptly relieved it. After spending a year in Austria my
patient returned to Dorpat to complete his studies in natural science and
philosophy and then travelled. So far as I know, he had not been sick since the
occasion noted above.
Case XI
Sycosis. Nux and Ipec.; Thuja,
Nat. sul.
Mr. Kľ, worker in a glove
factory, 28, tall and strong, of pale countenance and spare build complained
that for one year, especially in the autumn and winter months, he had suffered
from a cough, which was accompanied by a constant, generally copious, thick,
yellowish or greyish expectoration, which in the last attack was also mingled
with blood and this led him to seek advice. According to his report the cough
had not come on any single occasion from catching cold. He was not able to give
any particulars of his condition except that for year, or about the time that
the cough began, he had gonorrhoea, which had been treated according to the
old-school method and had only been cured about a month.
On examination of the genitals I
found over twenty narrow-pedicle condylomata about he glans and especially
around the corona. Percussion showed marked dullness in the upper part of the
left lung extending down into the third inter-costal space, while auscultation
demonstrated harsh bronchial breathing, which, in every case, points to
extensive infiltration. A distant weak vesicular murmur could also be heard in
the same side The third and seventh dorsal vertebrae were sensitive to pressure
The cough, which was agg. in the morning, was not debilitating. It was caused
by a persistent tickling in the throat which at night interfered with sleep, at
which time the cough was drier. His strength was lessened and also his
appetite. Cold water, cucumber and water-melon caused a watery, painless
diarrhoea, so that only boiled water could be taken and this in the smallest
quantity. The stool was sluggish. There was no fever but lately constant
chilliness not amel. in a warm room.
PAGE 64
On November 10th, 1868, he
received Nux 3x and Ipec. 3x, three drops in hourly alternation, and
anti-hydrogenoid diet. On December 1st he reported that he was feeling better
and that within a week the cough had nearly disappeared. The medicines were
continued at intervals of two hours. On December 10th the cough had not
returned, the chilliness was better and some of the warts had fallen off the
glans; there was an insignificant thin discharge from the urethra; he felt
stronger on the whole, his appetite was better and the stool regular. Physical
examination of the thorax showed a clearer percussion sound over the affected
area, and a somewhat rough, prolonged, but not bronchial breathing; the
tenderness over the spine was better. Thuja 30 and nat. sul. 2x were now
ordered morning and evening.
On January 12th only two of the
condylomata remained, the discharge from the urethra had ceased, as also the
chilliness, while the appetite, stool and general health were very
satisfactory. The remedies were repeated and on February 2nd all the
condylomata had gone. The chest showed everywhere normal percussion sound and
strong vesicular murmur. The tenderness over the spine was gone, the colour of
the skin was good and the patient’s former strength, through good appetite and
regular digestion, had again returned. No further medicine was given but he was
directed to report later. This he did on March 20th and I satisfied myself by a
thorough examination of his restoration to health.
PAGE 65
Case XII
Intermittent Fever and
Perihepatitis. Nux 3x and Arsen. 3x.
A wealthy lady, 30, mother of
two children, who had as a young girl taken for anaemia or chlorosis large
quantities of Iron in the form of Vallet’s pills, and had lost nearly all her
teeth in consequence, was taken ill in February, 1868, with a severe chill, accompanied
with sever pains in the right hypochondrium and pressure in the stomach which
was greatly aggravated by free respiration. This was followed by fever, not
intense, lasting several hours and followed by sweating. By this time it was
evening, and alter spending a bad night with frequently interrupted sleep, she
as alarmed to see her skin as well as her eyes had a strong icteric coloration.
From this time these attacks
began to manifest themselves in regular tertian type, during which the icterus persisted
in its intensity, but the pains in the hypochondrium lessened during the
apyrexia; no other symptoms manifested themselves.
The patient was treated up to
the beginning of May with old-school measures – soda water, soda baths and many
other remedies unknown to me – also with homoeopathic remedies, whilst all
possible diagnoses were given even to the presence of micrococci, but all
without relief. She then went to Carlsbad. There she drank of the Markt and
Muhlbrunnen, and bathed in Sprudelwasser, but the only relief obtained was that
the paroxysm changed from a tertian to an eight-day attack. During this long
interval the icterus almost disappeared, although the urine still contained a
large quantity of bile pigment and the faeces retained a white, bile-deficient
colour. After the patient had remained six weeks at Carlsbad without any
benefit she became impatient and losing hope of any results returned to her
home.
I was consulted the end of July
and found the following conditions : Very weak and emaciated, marked icteric
colour of the skin, with intensely yellow sclerae. The left lobe of the liver
was at least three inches below the borders of the ribs, extending to the
scrobiculus cordis; it could also be traced backwards to the middle of the last
rib and was very sensitive. The gall-bladder could be felt as a round elastic
body. The spleen seemed to be normal.
Over the whole body were
scratched and bleeding spots due to the itching from the icterus. The appetite
was poor, the tongue coated, a bitter taste in the mouth, the urine was filled
with gall pigment, the faeces chalk white, and the menses had not appeared
since February last. The paroxysm came on regularly every eight days at the
same hour, but on the seventh day the patient felt an oppressed feeling about
the heart, accompanied with difficult breathing and an indescribable
discomfort, due to the approaching paroxysm. The latter came on in the morning
lasting till evening and began with a light chill, followed immediately with a
severe pain of a pressing sticking character in the region of the liver,
extending also to the cardiac region causing there an unendurable distress with
difficult breathing. The fever was rather severe in character, lasting about
one hour, with little thirst but with intense aggravation of the pains about
the liver. During this time the liver was so sensitive that the slightest touch
could not be endured; the swelling of the liver and distension of the gall
bladder were also increased, whilst the sufferings could not be borne without
hot applications which afforded manifest relief. This continued until towards
evening, when the pains began to abate at the outset of a slight perspiration,
so that by ten o’clock the patient was again in a comfortable condition and was
only troubled by the increased icterus and persistent itching of the skin,
During the seven days’ apyrexia the swelling of the liver and gall-bladder and
the jaundice of the skin disappeared and the patient was able to move about and
take short walks in the garden. No headache or other disturbances were present.
PAGE 66
She received Nux 3x and Arsen.
3x, three drops of each in hourly doses, was ordered wine diet and to have the
body rubbed night and morning with alcohol. Th next paroxysm, also after an
interval of a week, showed itself only by a feeling of weakness and discomfort,
and the pains, swelling of the liver, chills and fever were wanting so that the
patient was not compelled to lie down nor to apply the hot compresses. On the
following day there was a sudden urging to stool, the movement consisting of a
partly formed white partly coloured pappy faecal mass mixed with a partially
thick, grass-green, watery fluid of fetid odour. From this time the decrease of
the swollen liver was daily evident. The gall-bladder could not be felt on the
day following the stool. The icterus slowly disappeared and with it the itching
of the skin, while the appetite at the end of two weeks was voracious, and as
the restoration of the whole organism went on the patient began to pain flesh,
to recover her strength. By the end of August, up to which time the medicines
had been continued, but at longer intervals, one would hardly know her. The
medicines were given once a day in alternation to the end of September, when they
were discontinued. There has been no relapse up to the time of writing.
PAGE 67
Case XIII
Sycosis. Thuja and Nat. sul.
Herr von Zľ, a feeble young man,
29, of delicate constitution, an officer of artillery, had, in October, 1862,
all the symptoms of gonorrhoea, having been exposed to infection, and in
addition an ulcer on the glans, which the attending physician at once announced
to be syphilitic.
A thorough use of Mercury (the
preparation unknown to the patient) both internally and externally, healed the
ulcer and reduced the acute gonorrhoea to a chronic, painless, insignificant
discharge. He was an invalid nearly a month and was discharged near the end of
November. During this treatment the health of the patient was much impaired; he
was pale and anaemic, with little appetite, and could not recuperate. In
December there was a pustulous eruption on the head, to which he gave no heed.
Soon after this he noticed a moist, sometimes painful swelling in the anus, and
finally also white spots in the mouth and throat. For all these he treated
himself, but without result. He then consulted a physician, who took all these
symptoms for secondary syphilis, and in consideration of his anaemic condition
gave him Iodides; but as these gave no result, the Protoiodide of Mercury as
prescribed, with the sole result of producing a profuse salivation. So the
Iodides were again resorted to. So went the treatment around without any
visible improvement until April, 1863.
PAGE 68
This led him to leave Kasan,
where he had lived, and come to Moscow. Here a so-called specialist in secret
diseases assured him of an ointment which was a sure cure and would remove all
the complaints after a very small quantity of the remedy had been used. He made
only forty applications and some of these to several insignificant mucous
plaques on the lips, which nevertheless the specialist affirmed were the
after-effects of the ointment already applied. In consideration of his weak
condition and the anaemia, as also from wise and secret reasons, the apparently
cured one was sent into a warmer climate. On the journey to Italy he was seized
in Turin with an angina, and consulting a physician, received large doses of
Sulphate of Soda, and later Kali chloricum internally and Iodine externally. He
as treated a long time without the slightest improvement in his condition.
Tartar emetic was then given, but in what doses the patient does not know. A
few days after taking this remedy the angina disappeared, as also the mucous
plaques with which it was complicated. After this, the now apparently
convalescent man spent some time in Italy waiting in vain for the favourable
action of the warm climate upon his strength, and then journeyed into
Switzerland, where he had another attack of angina. He was treated at a
water-cure, with the result of bringing back the mucous patches without
relieving the angina. This complete over-powering of the favourable action of
Tartar emetic, as shown in the cure at Turin, an account of which having been
given by the patient, surprised the doctor of the water-cure and made him prove
untrue to his principles, so that he prescribed Tartar emetic with the same
result as before. The again convalescing patient spent the winter of 1863 and
the summer of 1864, vainly waiting for returning strength and the disappearance
of the anaemia, part of the time being spent in Switzerland and part in
Southern France, until September, 1864, when he arrived in Paris. He then
suffered from a headache, which he thus described : The pain came in different
parts of the head, moved from one side to the other, and as for the most part
of a drawing and boring character and seemed to lie deep in the brain.
As the termination of his
furlough was drawing near he was prevented, perhaps fortunately, from calling
upon a Parisian corypheus and so travelled with his headache.
PAGE 69
In the beginning of October,
1864, he came to Moscow and put himself again under the care of the specialist
who had formerly treated him. Here he remained until December, being treated
with Russian baths and Iodide, but without any improvement, but on the contrary
with a progressive increase of his distress. On the 9th of December I was
called to attend him, and found the following conditions :
Pale, anaemic, wasted almost to a
skeleton, he lay in bed being only free from headache during the morning hours.
When the headache is on he can neither move, think or collect his thoughts. He
answered in a very low tone, loud speaking resounding in the head, so that he
presented an appearance of imbecility. He described the headache as deep in the
brain, but not located on any one spot, the pain being boring, gnawing,
tearing, and so severe as to cause him to rave and wish himself dead. The
headache generally begins between 5 and 7 p.m. , reaching its height at 12
midnight, and then declining with morning, so that between 7 and
It should be noted that the
above facts were not obtained at my first visit, but later on when he was able
to put them in order, since on my first visit his mind could bear only the
slightest strain. I gave him Thuja
PAGE 70
The result was so surprising
that at the end of one week the headache had improved to such a degree that he
was already more active and could now spend the day in comparative comfort. The
sleep also returned except just before and after midnight, when he had
headache; but it was easily endured, and this disappeared at the end of the
second week, the same remedies being continued. After this the appetite
returned, and by the 30th December his strength had wonderfully increased. By
this time the urethral discharge, which has lasted from the beginning of the
illness, was completely removed. The patient remained in Moscow until January,
1865, continuing the use of the remedies, without any return of the symptoms,
and once more he appeared in social life, attending parties, balls and the
theatre. At the latter date he went to Kiew, and soon after this he was
married. Two years later I heard that he was a father, and had never had a
return of his former conditions.
Case XV
Sycosis. – Arsen. and Nux.;
Thuja and Nat. sul.
N.N. , 38, and old-school physician
in Taroslaw, presented, on February 25th, 1869, the following conditions : A
small man, spare, wan, of weak constitution, had noticed for nearly a year a
swelling near the right sacral bone which measured near its base 11 c.m. broad and 14 c.m. long, and 1 c.m. high. It was surrounded by a hard, immovable,
not everywhere equally thick margin, with distinct fluctuation, so that by
touch its form could be determined and the presence of fluid ascertained. The margin
had the consistency of a hardened gland and simulated the latter in not having
the same thickness everywhere. The skin over and around the swelling was
normal, except where the frequent application of vesicants produced a livid
redness. OF the origin of the swelling the afflicted could give no other cause
than that he had for a so-called rheumatic pain and that the swelling had grown
very slowly to its present size. Of this previous history we learned that while
he had never enjoyed good health, he was liable to “catching cold”, and had noticed
that al his ailments were accompanied by chilliness, which was also true at the
present time. All his lesser indispositions presented an irregular intermittent
character.
PAGE 71
Many years before he had had
gonorrhoea, which had continued for an entire year and had been treated in the
usual manner, and even now from time to time it appeared, but was of short
duration. From this gonorrhoea had come a swelling of the epididymis.
The physical examination of the
chest, abdomen and spinal column gave only negative results, while the closest
examination by pressure and percussion failed either to produce pain or any
condition which might render clearer the puzzling cause of the swelling. It had
the appearance of an abscess due to congestion, an opinion which had been given
by one of the professors of the faculty. This professor had also advised an
exploratory puncture and the opening of the abscess; but this advice the
patient had not followed and was led to consult me.
In examining the history and constitution
of the patient it appeared to me very reasonable to consider the swelling as a
result of a sycotic rheumatoid dyscrasia, and with this view I ordered Thuja 30
and Nat. Sul. 2x, the former morning and evening and the latter every two hours
during the day, and to follow the diet of this constitution. On March 23rd the
abscess was smaller, the overlying skin relaxed, the muscular system was in
firmer condition, the patient felt much better and the colour of the face was
improved. Remedies continued.
On March 31st the abscess had
lessened one-half in size and the chronic epididymitis was smaller while the
general health of the patient was still improving. Remedies continued. On April
8th the abscess was reduced to a minimum and the epididymitis gone entirely. He
was now compelled to return home to resume his duties, but in August I heard
from him that he was then in excellent health, all traces of the abscess having
disappeared.
PAGE 72
Case XVI
Intermittent with Skin
Conditions. Nux 3x and Arsen. 3x, Thuja 30 and Nat. sul. 2x, then Silic. 3.
M.L. , 32, whose sister had been
a servant in my house for eleven years, of large size and good constitution,
now in her thirteenth year of married life; childless; had when a child and
also since her marriage, a scrofulous, oozing eruption on the head and face.
She had had only measles out of the list of children’s diseases. The menses
appeared when she was fifteen. The eruptions on the head were finally removed
after the long use of salves ointments. Soon after this she noticed a small
painful induration at the angle of the right lower jaw, which slowly increased
in size. In the autumn of the same year, 1867, she was seized with a severe
tertian fever with a hard and long-lasting chill, the attack persisting for
three months in spite of the use of Quinine and other remedies. Immediately
after the disappearance of the fever the above-mentioned induration began to
enlarge rapidly, became inflamed and suppurated; the latter continued for
several weeks with considerable destruction of tissue, leaving an unsightly
wound. In the Spring of 1868 she had another attack of tertian fever, which
again lasted three months, reappearing again in the Summer for a short time and
again in the beginning of July, this attack lasting for one week.
Towards the end of July an
eruption of tubercles appeared on the forehead, continually spreading and
covered with a thick crust, underneath which was a copious, pus-like secretion.
This continued for a long time and left behind a red, irregular, hard,
puffy-looking sore. The eruption slowly, spread over the forehead and temporal
regions and upwards into the hair, and was accompanied by an intolerable
itching. At the same time, with this eruption, there began a violent, at times
sleep preventing, dull tearing pain in the right upper jaw, which was agg; in
damp weather and accompanied with swelling which extended up to the eye. This
swelling rapidly increased so that by the end of September the right eye could
be only partially opened.
The anxiety due to the trouble
whit the eyes sent her from the country where she had been up to this time,
into the next government town, Nishny Novgorod. After a trial of remedies,
resection was advised, but to this she would not consent without my opinion.
This was in the end of September, 1868. Her condition was now as follows :
PAGE 73
Long continued chilliness with
flashes of heat; weak, feeble, emaciated, sallow complexion; on the forehead
the above-described eruption. The swelling of the right jaw was very prominent,
almost the size of my fist and reached to a level with the cornea, covering
nearly the whole cheek. It felt as hard as a bone, the skin over it was
unaltered, moveable and of natural colour and structure. Pressure on the
swelling caused no pain. Examination within the mouth showed no alteration of
the hard palate. The teeth were in normal position and firmness, but many were
carious and nearly all of them blackened, which was due, as the patient said,
to severe toothache, which came on like an intermittent, was long continued and
suddenly ceased. The space between the eyelids was greatly lessened, and the
eye continually watering, a trouble which had affected both eyes since
childhood. The vision was distorted; the pain was described as dull, tearing
and greatly agg. at night and in stormy weather; no headache, menses regular,
no leucorrhoea.
The appetite is fair, stool
regular, lungs normal; no trouble with digestion; aversion to fish, which she
cannot look at, to say nothing of eating, nor can she bear warm or cold baths
since these produce either fever or toothache or pains in the limbs or
headache, so that she very seldom, or only for the sake of cleanliness, uses
the bath-tub.
Whatever the diagnosis, the
eruptions could not be definitely defined, since the spot was covered with a
thick crust from beneath which could be pressed in large quantities a purulent
watery discharge. The previous attack had left no scarring. In consideration of
the papules, the profuse suppuration and the existing bone-swelling I could
only conclude there was tuberculous infection with lepra characteristics. The
swelling of the upper jaw was diagnosed as an enchondroma. The ground on which
this affection grew must, according to all examples, be due undoubtedly to the
sycotic-hydrogenoid constitution, and this was confirmed when we knew that the
patient had always lived near the Volga, and that in the Spring the high water
reaches to the windows, and the land itself was low and boggy. On account of
the frequent returns of the intermittent fever, which was not cured, as shown
by the still long-continued chilliness, and seeing that it had probably been
suppressed by the large doses of Quinine, I gave Nux 3x and Arsen. 3x. in
hourly alternation of three to four drops each; also the wine diet and strict
avoidance of articles forbidden by the hydrogenoid constitution.
PAGE 74
By the middle of October there
was general improvement. As I did not expect these remedies to have any marked
effect on the eruptions and bone swelling, I gave Thuja 30 and Nat. sulph. 2x
in the same manner as before.
In the beginning of November the
eruptions had almost disappeared, there was no discharge, and the itching and
reddish discoloration had lessened, while the swelling, at least, had not
increased and the pain was very much reduced. At the end of November the tumour
has softened and lessened. On December 12th there was a further change in the
tumour but the eruption had entirely disappeared. At this time she was called
home and received Silica
Case XVII
Hydrogenoid Menorrhagia. Nux and
Arsen.; Nat mur.
Madame A. Lľ, mother of two
children, of robust constitution, fleshy, never had a severe illness,
menstruation regular and copious until the autumn of 1867, when her menses came
on in an unusually severe form. At first she thought little of it, but as it
continued beyond the accustomed time she became worried and consulted me.
Careful examination failed to discover any cause for this menorrhagia. The
appearance of the flow was about natural, but the quantity had increased to a
haemorrhage. There was no pain, functions of the body normal, and before the
onset of the menorrhagia there had been nothing to complain of. Under these
circumstance it was not easy to apply a remedy, and one after the other of
those prominently indicated for haemorrhage for one week failed. Salina
afforded a passing improvement for one week only. She was nursing her youngest
boy and thinking this might be a possible cause it was forbidden. With the
onset of Winter, which was a dry and unusually severe one, the menorrhagia
ceased. She was neither emaciated nor weak, although the haemorrhage, with
brief interruptions, has lasted two months. During the winter the menses
appeared several times in normal quality and quantity. In the early Spring,
which was a very damp one, the haemorrhage returned, and as the patient had
lost confidence in homoeopathy and myself, another physician was consulted. He
ordered injections of Ferrum sesquichlor, and gave internally Iron, Secale
cornutum and acids, but without the slightest relief.
PAGE 75
In October, 1868, on my return
home after an absence of several months, I was again called to see the patient
and learned that the haemorrhage ceased on the outset of warm and pleasant
weather, but that at the beginning of the rains and cold weather – which was in
the early Autumn – the haemorrhage had again returned and with the same
conditions. A most thorough examination failed as before to show the slightest
cause for the condition. Noticing now that the attacks ceased in Summer and
came on in the Autumn I asked concerning damp weather or baths, and whether
fish, milk and fruit agreed, but to these questions no definite or satisfactory
answers were obtained. However, Nux 3x and Arsen. 3x were given in hourly
doses, and the wine and hydrogenoid diet ordered. On the next day the
haemorrhage ceased and remained away two weeks, but returned again after the
patient had been out on a very wet day. I strictly forbade going out in similar
weather, gave the same remedies and ordered the whole body to be rubbed every
morning with brandy. The next day the haemorrhage ceased and did not return
until July, 1869, after she had remained for a long time during rainy weather
in a building which was not perfectly dry. During this time the menses appeared
in normal quality and quantity and without pain.
PAGE 76
The remedies were given at
longer intervals and in higher dilutions while the diet remained unchanged.
When the haemorrhage again returned I gave Natrum mur. 9, two drops every two
hours and after a few days the haemorrhage was again controlled. A few months
later I was informed that she was pregnant.
Case XVIII
Sycotic Tumour. Hepar 3x, Thuja
30 and nat. sulph. 3x.
Johann v. T., 37, of strong,
robust constitution, a cavalry officer, consulted me in August, 1869,
concerning a swelling on the thigh which had existed since 1859, and for the
past seven years he had been unable to walk except with the help of a cane, and
even then not without limping. The swelling was on the left thigh, almost at
the middle, in the rectus femoris muscle, having an elliptical shape and
measuring 6 ˝ inches long, 3 ˝ inches broad and
PAGE 77
The general condition, although
satisfactory, had, in comparison with his former state, greatly declined. The
mind was weakened, spirits depressed, he was easily excited to anger,
especially over trifles, which was not the case formerly.
The previous history was as
follows : He had never suffered from an acute affection but, on the contrary,
had always enjoyed unusually good health. In February, 1855, he had, after an
illicit intercourse, a small, slimy, itching sore on the inner surface of the
foreskin which healed of itself in a short time. In October, on account of a
similar cause, the same sore appeared, was pronounced syphilitic, was treated
in the usual manner and healed in a month.
In the Spring of 1856 he was
attacked with intermittent fever which continued for several months, showing
first a tertian and then a quotidian type. After the fever had been cured with
large doses of Quinine there again appeared an ulcer following as before an
exposure, which was treated with Mercury but was slow in healing. The
intermittent fever appearing during the period, the Mercury was alternated with
Quinine, and now the ulcer and the intermittent promptly disappeared. A few
months later balanitis appeared but was promptly relieved with a lead wash.
In the winter of 1857, the sore
which was supposed to have been healed in the previous year again opened, and
was healed as before with the sublimate. The ulcer again healed, and in the
Summer the patient took on his own responsibility, to cleanse the blood, a
so-called “Spring-cure”, or Sarsaparilla decoction. But in order to secure a
sure result he mixed Colbert’s essence with the decoction. In the winter of
1858 the ulcer again appeared without apparent cause in spite of the previous
prophylaxis; probably the blood-cleansing liquid had not washed it
sufficiently. Colbert’s essence was given and the ulcer again disappeared to be
followed by a balanitis, which was also cured.
PAGE 78
Now the patient began to feel
and exhausted, with falling out of the hair and an uncomfortable feeling of
weight in the left thigh, with difficulty in bending the limb, especially at
the knee-joint. Later there was an increase in the circumference of the limb.
IN 1859 he had a left-sided orchitis without apparent cause, and now Kali
iodatum and leeches joined the series. These benefited the orchitis, but it was
followed by a furuncle on the lower leg with long-continued suppuration which
was healed with Muriate of Soda. To these conditions was added a dry cough,
accompanied with retching an continuing throughout the day accompanied each
evening with chilliness. This was treated with Rhubarb and Quinine pills. The
swelling in the high now increased rapidly and had in 1863 reached quite a
size. In 1865 the trouble had increased still more, notwithstanding the use of
Merc. iod. and Sublimate and other remedies, including baths and ointments,
with the result only of producing numerous furunculi over the whole body.
Finally, losing all hope of relief, since several consultations of professors
had been held over his case, he came to me.
On account of the
often-reported, falsely considered syphilitic and mercury mis-treated ulcer,
the balanitis, orchitis, furunculi, the characteristic scarrings, the
appearance of the same general affections in different organs as well as the
intermittents and the characteristic cough, due to the long-continued use of
Quinine, it was only possible to arrive at one diagnosis, namely, a blood
infection on a sycotic or hydrogenoid basis. The swelling on the thigh was also
considered a neoplasmus due to the same cause.
There could be no doubt about
the preliminary treatment. All salves and ointments were laid aside and dry
charpie applied to the suppurating sores, and a wine and hydrogenoid diet
ordered. In order to antidote the effects of the Mercury, although no
salivation had been produced, I gave in August, 1869, three drops, three times
daily of Hepar sulph. 3x. In September there was a general improvement and now
Thuja 30 and Nat. sulph., 3x was given. IN the latter part of October the pains
in the leg had disappeared, the swelling had greatly lessened and he was able
to move so well that at an evening company he had been able to dance a polka.
In December, 1869, the swelling measured exactly 1 ˝ c.m. long and about the same width. All ulceration
as well as the hard scars or spots had disappeared. He walked freely without a
cane and could move the limb without difficulty in any direction.
PAGE 79
The remedies were repeated at
longer intervals. I often saw this patient during the following ten years; he
had married, was a father and was not again sick.
Concluding remarks by dr. bojanus
Whoever will take the trouble to
compare what is here written upon the causes and character of the
disease-relation with what Grauvogl has stated in his writings on
“Intermittents” will see that very much of what is there written is here fully
confirmed. At the same time he will also see the necessity of asking himself
this question – Whether it is possible, without the knowledge and recognition
of these constitutions, to cure such cases as safely and in as comparatively a
short time with such moderate therapeutic measures?
I am well aware that the history
of special cases of sickness is convincing only to those under whose eyes they
take place, and who themselves are interested in them in their professional
character. This is also to be regretted because of an inviolable law that man
never becomes wise by the experience of others but only by his own, if he
becomes so at all. We should think an hope, therefore, that in a science like
ours, in which three of four lifetimes, if they were allotted to one human
being, would not suffice to learn more than a small part of it by personal
experience, that the experience of others should at least stimulate examination
especially by the more highly educated classes to which physicians belong as
well as by those who are advanced in mental culture. And this the more as they
put off prejudices and reject them, and when men who on the field of research
have made their mark point out doctrines that differ from ordinarily accepted
views it by no means follows that they are incorrect or false.
PAGE 80
Thus, for example, B.H. Gross, who in matters of science must have
more than one voice if his achievements are appreciated, says concerning the
doctrines of the constitutions of Grauvogl :
”Grauvogl’s fundamental laws
have been declared impracticable by men of opposite views, by some out of mere
dogmatic habit, by others because they found it too inconvenient to bind their
accustomed arbitrary proceeding to study laws. Grauvogl’s works they would
study them for their own interest; for the fundamental characters of
constitution alone render it possible, to a certain degree, to generalise
without becoming unfaithful to homoeopathy. As epidemic constitutions they must
be very important for the diagnosis and treatment of climactic diseases in all
countries of the world. They make it possible to cure with one single remedy a
complicated constitutional ailment”.
Dr. B.H. Gross quotes the following pertinent Motto.
“A physician is he who lays open the wonder-works of God to each and every one.
For what is n the sea that may be hidden from the physician? Nothing! What is
in the earth that he should not open? Nothing! He shall bring it forth and not
alone in the sea, in the earth, in the air, in the firmament! Requirimus in medico
non solum microcosmi sed etram universae naturalis philosophiae cognitionnem,
non ex phantasmibus ac speculatoribus sed sensuum et experimentiae judicio
exortam”.
Paracelsus.
”The doctrine of Constitutions
as Grauvogl teaches it in his Text-book had found very little favour in Europe,
but somewhat more in America; whether justly must be evident by good will to
anyone that is free from prejudice”.
A recent case
To the above record and remarks
of Dr. Bojanus I may add a recent case of my own.
PAGE 81
A man of 60 who had long been
subject to nasal and bronchial catarrh with asthmatic complications, though
otherwise well, after some years’ residence on high ground, returned to a
former residence close to the river. All his old troubles returned in great
intensity. On January 1st, 1926, he was put on the double salt of Mercurius
biniodatus and Kali iod. 3x, gr. viii., night and morning. Under this he made
great progress for a time, but had a bad relapse in which it ceased to help. An
“awful running, sneezing head-cold’ came on, leaving congested nose, cough with
whitish expectoration, difficult breathing and depression.
I prescribed on January 20th
Ipec. 3x, discs half and ounce. Two discs to be taken every three hours; and
Nat. sulph. 3x, ten grains night and morning. I told him also to confine his
baths to one a week, and on the other days to be content with a brisk rub with
a rough towel in the morning on rising.
March 4th. Very much better.
Still discharge from nose but not so bad. Repeat.
March 22nd. He reports : “I am
pleased to tell you that I am very fit and that all my old troubles are very
trifling”.
So he is not thinking of
changing his residence again for the present! The medicines were continued.
PAGE 82
The oxygenoid constitution
The oxygenoid constitution
Concerning this “Constitution”
Grauvogl has more to say than on either of the other two, but he gives no
illustrative cases since he considers this unnecessary. Bojanus says he has
only seen one typical case of the kind.
As the Hydrogenoid constitution
hinders the proper oxygenation of the blood and tissues by a predominant
waterlogged or hydrogenous condition, so the oxygenoid tends to an excess of
oxygen and consequently exaggerates breaking down of hydro-carbons, nitrogenoids
and albuminous tissues and bones. We see this in syphilis and its analogue in
medicine – Mercury. Thus the oxygenoid constitution corresponds to Hahnemann’s
Syphilis and also to Bazin’s.
This constitution, whether
inherited or acquired is of a grave character, says Grauvogl. The blood is a
product of the organism and its elaboration is handed down from parents to
children for generations. Immunity may also be inherited. A weakened power of
resistance against the destructive energy of oxygen may be acquired by attacks
of acute epidemic diseases and by syphilitic infection. The incubation periods
required by these diseases between the original infection and the outbreak of
symptoms is the period required for the increase of the poison up to the degree
necessary to make it efficient. These poisons must therefore be living
organisms, which induce the most intense processes of reduction, so changing
the constitution of the body as to render it unable to resist an immediate
influx of oxygen.
It will thus be seen that
Grauvogl included under the term “Oxygenoid” much more than is included in
Hahnemann’s and Bazin’s “Syphilis”, just as “Hydrogenoids” included more than
the results of Gonorrhoea. As for Syphilis itself, Grauvogl believed it quite
possible that his poison should arise de novo from ferments generated in impure
vaginae and that it depended on the constitution of the individual in question
which disease followed from one and the same exposure. “From the same woman on
the same day, and indeed in the very same hour, one may get a syphilitic ulcer,
one a sycotic ulcer and one escape without any infection”. Somewhat parallel
with this I have seen a distinct case of syphilis develop in a woman when her
partner for months past never had and never developed syphilis; and I have seen
a very inveterate urethritis in a man whose wife suffered from leucorrhoea and
with whom there was no question of other intercourse. Burnett held much the
same view that Grauvogl did, that poisons were generated by the contents of
vaginae of women who had connexion with numbers of different men.
PAGE 83
It all depends on the
constitution of the recipient, says Grauvogl, which disease is communicated.
“Only within and in connection with the Hydrogenoid constitution does the
vaginal poison become the cause of the sycotic secretion of the so-called
gonorrhoea. It can produce gonorrhoea as well as ulcers; but these are not
cured or benefited by Mercury, but aggravated”. The sycotic, hydrogenoid
dyscrasia follows the suppression of these diseases by injections or by local
measures.
On the other hand, the so-called
Chancre-dyscrasia is produced from the Oxygenoid constitution. “Chronic
diseases which result from these conditions from the begetting of the
Chancre-poison” will be cured by Mercury, while Thuja or Nat. sulph., the
hydrogenoid remedies, will aggravate.
Speaking generally on the
remedies for the Oxygenoid constitution, Grauvogl says, that on account of too
active an influence of Oxygen on the body this seeks its remedies mainly in the
Carbon an Nitrogen series which prevent the oxidation of tissues. “Rademacher
places Iron in the first rank, but I put first Hydriodate of Potash – Kali
iodatum – because it absorbs all the ozone. Here the carbon and alkalis rich in
carbon have a different effect, as Graphites, Petroleum, Kreosote, Benzoic
acid, Citric acid, Hydrocyanic acid, Laurocerasus, and, chiefly for inductive
reasons, Antozone water, corresponding indeed to iodosmone water. Furthermore,
Nitric. acid; also many so-called narcotics, especially Aconite. Moreover,
China, Quinine and Arsenic (given alone and not in alternation with Nux); and
also the metals which are capable of suspending the process of decomposition,
hence Chromium and Kali bichromicum”.
PAGE 84
It will thus be seen that
remedies for the Oxygenoid constitution are largely anti-syphilitic remedies as
recognised in homoeopathy. And Grauvogl expressly states : “The law of similars
must always decide the special indication”.
Dr. Pascal, in an article contributed
to the Bulletin de l’Homoeopathie on Grauvogl’s Constitutions, gives the
following summary of the Oxygenoid which may be usefully appended, although in
may appear to involve repetition :
In this oxygen predominates, or
rather the proteid matters are struck with instability with a morbid facility
of division.
Oxidations are rapid though
often incomplete. Consumption of tissue arrives more rapidly than in normal
conditions of life. Hydrocarbons and albuminoids being rapidly burnt up leave
the tissues defenceless against the burning power of oxygen. Oxygenoids are
thin and weigh less than carbo-nitrogenoids of equal volume. This provokes the
using up of proteid materials and the cellular framework. Scrofula, rickets,
infantile atrophy and various states called “anaemia” result from this.
Oxygenoids feel better in an
atmosphere saturated with nitrogen and carbon, in the midst of resinous, fatty
or empyreumatic vapours.
They refuse easily oxidizable,
animal foods, and seek for fats and hydrocarbons which oxidise slowly.
They are worse when dryness is
changing to humidity, before storms, before and during tempestuous winds and
better when it begins to rain or snow and the electric equilibrium is restored.
They are worse in foggy weather,
and when, with a temperate air, mists rise from the forests. This is the
opposite of what obtains in the carbo-nitrogenoids with whom fogs, like those
of England, provoke melancholy and tendency to suicide.
Nevertheless there is a certain
rainy time which relieves hydrogenoids and aggravates oxygenoids. This is when
the air is charged with ozone and the highest points of the mountains are not
covered with mists.
PAGE 85
In brief, electric disturbances
aggravate, and electric equilibrium relieves oxygenoids.
In the last analysis the
phenomena can be traced to a plus or a minus of atmospheric ozone. Electric
attractions polarise atmospheric oxygen and transform it into ozone (oxygen
polarised negatively) and antozone (oxygen polarised positively); it is after
undergoing this modification that it becomes an effective and energetic
oxidizer. Electric disturbances then act as hyperoxidants and this accounts for
their aggravations.
However, watery excess enables
hydrogenoids to bear hyper-oxidation better, for it demands s till greater
storage of heat. This is why rainy weather, charged with ozone, relieves
hydrogenoids under certain circumstances whilst it aggravates oxygenoids.
Other symptoms constantly found
in oxygenoids are :
Excessive elimination of urea
and phosphates;
Plethora – great quantity of
blood;
Much oxygen fixed on the
haemoglobin;
Excessive thinness.
Animal heat, strong after meals
and feeble in the intervals.
Vigorous appetite which persists
astonishingly during illnesses.
Abstinence, on the contrary, is
badly tolerated.
Amel. by Rest and Food.
Agg. by Cold, Sea-air, Low
altitudes.
Oxygenoids are what are commonly
called nervous individuals characterised by great physical and mental activity.
Treatment
Grauvogl puts in the first rank
Kali iod. since it absorbs all the ozone. Rademacher gives the first place of
Ferrum.
Among remedies having a direct
action on oxygenoids are the Carbons and compounds rich in carbon, Graphites,
Petrol., Benzin., Citric ac., Hydr. ac., Laurocerasus, and also, by inference,
Antozonised water, which is probably equal to Iodosmised water (l’eau
iodosmée); Nitr. ac. and a great number of bodies capable of checking the
destructive process : Ars., Chi. sul., Chrom., Kali bichr.
The law of similars always
decides special indications.
PAGE 86
Carbo-nitrogenoid constitution
Carbo-nitrogenoid constitution
This constitution is
characterised by insufficient oxygenation and the diseases it produces are
called diseases of retarded nutrition. This makes for increased liability to
disease and perverted nutrition.
After a period of obesity,
thinness follows. Albuminoids are decomposed like the hydrocarbons. There is
pseudo-albuminaria, phosphaturia, acetonemia, rickets and osteo-malachia.
General symptoms are great frequency of respirations with shallowness; short
breath, frequent pulse, blood charged with melanotic cellules. Constipation or
diarrhoea, flatulence, urinary troubles, gouty pains in the head, gouty
swellings, vertigo, ataxia, dullness of the head, somnolence, yawning,
hypochondriasis, irritability, and extraordinary impatience.
Copious uric acid and oxalates
in urine. – Epistaxis and haemorrhoids. – Pruritus. – Precocious baldness with
perspiration of the head. – Cerebral fatigue. – Unhealthy skin, fetid and acid
perspiration, boils, eczema, urticaria.
Causes of aggravation
1. Everything which hinders
oxidation.
2. Everything which increases
hydrocarbons and albuminoids.
3. Everything which diminishes
the alkalinity of the humours.
Agg. Rest. Agg. Non-ozonised
mists.
Agg. Irritation of
cerebro-spinal or sympathetic nervous system.
Agg. Sexual excesses.
Agg. Over-feeding.
Agg. Confined air.
Agg. Chagrin.
Agg. Respiratory insufficiency.
Agg. Loss of blood or blood-letting
which diminishes the number of blood globules and consequently oxidation.
Agg. Excess of Sodium salts,
like sea salt, which hinders cellular osmosis and diminished the quantity of
water in the tissues.
PAGE 87
Treatment
The Carbo-nitrogenoid lacks
ozone and is rich in carbon and nitrogen. Consequently it finds its chief
remedy in ozone and ozonated water.
Applicable also are all remedies
which facilitate the splitting up of hydrocarbons and albuminoids and the
discharging of oxygen chemically into the heart of the tissues. For example :
Cupr., Phos., Sulph., Camph.,
Hepar sulph., Aco., Merc., Aur., Argent., Plumb., Plat., Ol. tereb., Rhus.,
Dulc., Cham., Lyc., Bov., Bel., Nux. 30 (alone – not alternated as for
Hydrogenoids), Digit., Hyos., Apis., Lob. infl.
PAGE 88
Practical examples of the carbo-nitrogenoid constitution
The carbo-nitrogenoid constitution
Case I
Dyspnoea, Palpitations, Asthma,
etc. Arg. n.
[Symptoms in italics are found
in the provings of Argent. nit.]
Jľ.Lľ., a police officer, 54,
complained that for a year past he could no longer satisfy his desire for
hunting because, when ascending a hill or on moderately rapid motion he loses
his breath. He stated that he suffered from piles and had always taken many
powders and pills which relieved him, at most, for a day or two, and that now
his digestion is so much impaired by having taken them for years, that for many
months he has suffered from loss of appetite. Previously corpulent, he was now
emaciated and has to complain of a constant anxious feeling in the region of
the heart, periodical pains in the abdomen, burning haemorrhoidal tumours and
urgency to urinate. He was most alarmed by the frequent vertigo and weakness of
the whole of the left side of his body. He has a prematurely old took, ashy
pale colour of the skin, the tongue was coated white, the taste unpleasant, the
region of the liver sensitive to pressure though no enlargement of the liver
could be discovered. No blood or mucus was passed with the stools. Respiration
26, pulse 108; palpitation of the heart; no cough, the respiratory murmur
scarcely audible in several places; only on the upper part of left lung was it
dry, vesicular and manifestly more acute. When requested to draw a deep breath
he did it without pain but with so little elevation of the thorax, with so
small a quantity of air being inspired, and without being able to hold his
breath for any time, that is was clear that the capacity of the lungs was much
diminished. The hands trembled; the sleep was short and he awoke frequently
with attacks of suffocation. Discharge of wind upwards and downwards always
brought relief. He had lived moderately ever since he could remember.
PAGE 89
Soup, meat, vegetables, milk,
coffee and two glasses of beer a day were his food. He walked two hours every
day in the open air and never smoked.
The use of coffee was forbidden
and Nux vom. 2 was prescribed provisionally once a day for eight days, then set
aside for eight days, and so on.
For eight days he thought he was
feeling better, that is, in general only, for all his complaints remained,
though in a less degree.
Four weeks later at
For the next six weeks
everything remained much the same. But now he earnestly begged for something
against the constipation; for after two or three days without an evacuation
there regularly returned intense weariness and more trembling of the hands;
then also more sleeplessness and disgust for all labour; heaviness and
stupefaction of the head, especially the occiput; eructations and sense of
constriction in the bowels, as if tightly girl by a band, which had chiefly set
in after the last asthmatic attack. The urgency to urinate also increased,
while he suffered from obstruction; also the palpitation and difficulty of breathing,
as well as the sense of weakness of the left side of the body, and the left arm
became hen as heavy as lead.
Thus Sulphur was clearly not
indicated, the improvement being too trifling.
In view of the proving of the
Carlsbad springs by Dr. Porges, I thought best to advise the patient to take
every morning half a teaspoonful of Carlsbad salts in half a pint of water.
PAGE 90
This advice was followed for two
weeks when, suddenly, for the first time a haemorrhoidal bleeding ensued with
great relief of all his complaints. The relief did not continue long, however.
With the spontaneous cessation of the haemorrhages, during which no remedy was
taken, the previous ailments came back In this way a whole year passed and I
had to confess to myself that nothing worth mentioning had been accomplished,
although the patient was content.
It is certain that in this case
the life of the blood was the primitive seat of attack, and it is equally
certain that the insufficient nourishment of the nervous system thence arising
proved all these symptoms taking their origin in functional changes in the
brain and spinal cord. With this man the entire interchange of substance as
impeded by insufficient oxidation, and among those remedies which are able in
any way to increase the influence of the oxygen upon the system I found only
one which as at the same time indicated according to the law of Similars,
Argent. nit.
Here, however, let me point out
that our patients, whether they take Arg. nit. by drops in spring water (for
they have no distilled water), or use pellets medicated with Arg. nit. and then
dissolved in spring water, never really take Arg. nit. into their blood, but
only Chloride of Silver – Argentum muriaticum – and the higher the attenuations
are the more certain this is, because all spring water contains no small amount
of Chloride of Sodium. If a few drops of the second or even the third decimal
attenuation be put into a spoonful of water a white cloud of Chloride of Silver
is formed at once. How far this may go is clear from the observation that even
the fourth decimal attenuation of Arg. nit., and ounce of it, for instance,
clearly presents to the light a reddish-brown cast.
[I may interpolate that although
the actual substance may be Arg. mur. and not Arg. nit., the Arg. mur. is in a
nascent state when taken into the system, and the effect may not be identical
with Arg. mur. otherwise prepared and administered. – J.H. C.]
PAGE 91
J.L. was now ordered to take for eight days, night
and morning four or five drops of Arg. nit. 2x, in a spoonful of water. I
prefer to prescribe it in this way because the Chloride of Silver is then
always freshly prepared, as had doubtless been the case in the provings.
When J.L. presented himself at the end of the eight days,
I was not a little surprised, as soon as he entered the room, by the very
decided change in the colour of his face (for he was the first patient to whom
I had given this prescription according to the above-mentioned indications).
His face had assumed once more the incarnadine pale red colour of healthy men,
and he himself declared, with beaming face, that he had never felt as well as
he did then for twenty-five years past. This alone proved that increased
oxidation of the blood had taken place. Moreover, the pulse had dropped to 90
and the respirations to 22; proof enough of increased capacity of the lungs in
accordance with which the patient drew a deeper breath, the thorax expanded
more, and the breath could be held for a longer time.
But even the reciprocal action
in the nervous system was made evident by the restoration of quiet sleep, often
lasting five or six hours, and the disappearance of the “band” round the
abdomen, a sure sign of an affection of the phrenic, or diaphragmatic nerve.
I now stopped the medicine for
eight days, but nevertheless the improvement continued the stools became more
regular and there was seldom any sign the vertigo. Without further medication
of any account the cure continued and for three years thereafter he had no complaints.
Case II
Headache, Vertigo, Dyspnoea,
Palpitation, etc. – Arg. nit.
A blooming girl of 19,
menstruating regularly, suffered for five years without interruption from
pressing pains over the whole head, sometimes only on the vertex, sometimes on
the left frontal bone, which were agg. by firm pressure on the painful parts,
and were ascribed to immoderate dancing in the evening, while the many
physicians whose advice was sought had been able to give no relief whatever. On
being questioned the patient further states that she suffers from vertigo and
is easily tired, whilst at the same time she is losing her memory. On going
upstairs her breathing is hurried and she has palpitation of the heart. The
tongue is coated white. Appetite and sleep are very good, but she is too sleepy
during the day; pains in the stomach here and there, frequently for weeks at a
time, with nausea and vomiting even. On feeling the pulse I noticed a trembling
of the hands; pulse 98; a burning feeling in the region of the heart; she can
breathe pretty deeply without pain, but cannot hold her breath long, and on
breathing only vesicular respiration can be heard, yet there is no cough. The
urine is pale and poor in solid constituents. Nothing more was to be learned.
PAGE 92
After the fourth dose of Argent.
nit., 2, the girl as relieved of all her headaches and she could afterwards
breathe much more easily. Her palpitation was relieved also, and her memory
returned in full force, for which an interval of five days only was necessary.
Case III
Calculous Pyelitis – Arg. nit.
A woman, 37, of lively
temperament and healthy appearance, who was married and had given birth to one
child, and had recovered well from her confinement, had suffered during the
last three years, without any known cause, from attacks of so-called nephritic
colic recurring periodically every three months. Attempts were made to relieve
the excessive pains by the applications of leeches to the region of the kidneys
on both sides, and by the use of purgatives, and it was only after the patient
was reduced to the last degree by this treatment that the pains gradually
remitted.
On account of her change of
residence I was called in to see her in her last attack and found her in most
acute pains in the regions of both kidneys, the pains extending down the
ureters to the bladder. She was lying motionless on her back, since every
motion of her body caused her inexpressible pain, and touching the region of
the kidneys increased these pains in the highest degree. She was perspiring
freely; pulse 130; she sought by frequent and short breaths to avoid deep
inspiration, for this increased her pains insufferably. The urine contained
blood, was scanty, passed often, but only a little at a time and by drops. It
contained a visible sediment of crystallised uric acid and pus, with amorphous
gravely concretions, some as large as half a lentil. The clear urine above the
sediment was acid and gave a deposit when heated with nitric acid. Thus it was
clear that I had a case of calculous pyelitis to deal with. She begged to have
leeches applied, as she had some ready and previously she had always
experienced relief from them. But nevertheless, she was afraid to incur the
pain of turning on her face, which the application would have necessitated, and
so was dissuaded from their use on the promise of receiving relief in some
other manner. This I could promise when I prescribed Arg. nit. 2, four or five
drops every hour.
PAGE 93
When I saw her again after six
hours she was very grateful to me for such prompt relief and so easily
accomplished; for a quarter of an hour after she had taken the first drops she
felt greater relief from her pains than was previously the case under the use
of leeches. She was able to urinate at once without hindrance, and more
copiously, and she was already lying without pain, yet motionless, because the
least motion renewed her pains again. On this account she restrained the urine
as long as possible; this has been impossible before, but could now be accomplished
with ease.
Next morning the pulse was 80
again, and she breathed as when in health. After eight days no more uric acid
crystals were passed, but only small concretions. She showed me one of the size
of a lentil, which she had passed without pain, and that was the last sign of
her disease, which had lasted three years.
For curiosity I had taken some
of the urine on the first day for further examination. Besides what has been
already mentioned, it contained no trace of triple phosphates, but the well-known
epithelia of the mucous membrane of the pelvis of the kidney. Hence the pus
could not have come from the bladder.
Three years have now passed
without a relapse.
PAGE 94
Case IV
Hydrogenoid converted by
Treatment into Carbo-nitrogenoid and cured with Argent. nit.
A woman 29, was thought when yet
a girl of 15, on account of a pneumonia which she had at that time to be
tuberculous on account of her brilliant eyes, white teeth, white, transparent
skin, and because absorption of the exudation did not take place in connection
with the cough which still continued and the purulent expectoration. Cough and
expectoration, however, disappeared spontaneously in the course of a year.
The patient continued apparently
well till she married in her twenty-first year, and had a miscarriage. From
that time forward all sort of troubles broke upon her – at one time anomalies
of menstruation; at another pains in the ovaries; now spasmodic cough,
palpitation of the heart and symptoms of so-called anaemia. All these, however,
were transient, and no medical aid was called in.
Four years after that
miscarriage she sought my advice for hoarseness which had already lasted five
weeks. A suspicious fluor albus was connected with this, and I gave her Nat.
sulph. to be taken every three hours. The results was really remarkable, since,
even on the second day there was but little of the hoarseness left, and on the
third day none at all. The fluor albus diminished and after a fortnight ceased
entirely.
Six months later she sent for me
in haste on account of a spasm in the chest.
It was a common dry asthma. On
the lower part of the left side where she had felt the stitches during her
former pneumonia, the sound on percussion was dull and no respiratory murmur
could be heard. On the upper border of this spot there was a distinct fine
crepitatory mucous rattle. Drawing a deep breath gave pain in the part, and a
sound of broncophony was heard. The middle and upper portions of the lung as
well as the entire right lung were sound. The cause of all this was a violent
mental emotion.
PAGE 95
This woman had but little colour
in her face and pale lips. She was not much emaciated, but well-formed and
slender; had no phthisical appearance; the appetite and sleep were good. The
menses have been regular for a long time; rather too copious and followed for a
day or two by a mild fluor albus. Her parents, still living, are quite healthy.
After her attack of asthma, which lasted half an hour, her pulse stood at 90,
and her respirations 21. For eight days one dose of Phos. 6 was ordered every
day.
Called to see her about a year
after I found her suffering again with a violent attack of asthma. She merely
complained of want of air and fear of suffocation. Her condition was
substantially as before, and as she had been quite well since, except for a few
slight spasms of the chest, Phos. was ordered again as above. The spasm of the
chest ceased, but a great weakness remained, lasting for several days and she
remarked that her whole left side especially was of little use to her.
Objectively there as no anaesthesia to be discovered. She confessed that she
became angry very easily, and whenever she did she always suffered for many
days from stitching pains in the affected parts of the chest. I recommended her
to take Aconite a few times after every such mental emotion.
A few weeks after this she had
hoarseness again. Nothing was revealed by the laryngoscope. After taking Acon.
every hour for three days profuse sweat set in, during which the hoarseness,
which she supposed originated from a cold taken when washing, ceased.
Six months later, having been
living for a years near the water, she had a quotidian fever in the autumn,
with increase in the stitches in the side and with cough during the paroxysm.
Both disappeared always with the sweat. Nux. and Ipec. put an end to these
attacks in three days; yet only temporarily, for the next summer she suffered a
relapse; but now more expectoration which was clearly puriform, and which was
mixed with light blood. Chin. sulph. 3 removed all these symptoms in ten days.
It was remarkable that the stitches in the side, the cough and expectoration,
at each time, lasted only so long as the paroxysm of the intermittent, and that
during this time from the part of the left lung originally diseased, there was
a coarse crepitant râle extending to the large bronchi manifest on
auscultation.
PAGE 96
However, as often as she got
angry the chills returned as well as the stitches, cough and expectoration
mixed with blood.
The patient could never be
persuaded to take care of herself for any length of time, nor would she stay in
bed except during the paroxysms of intermittent; and since these attacks of
cough produced by passion were not seldom accompanied with vomiting also, I
gave her Antim. tart. 3, which always gave her prompt relief and deliverance
from her sufferings; but they always returned again from the same cause.
Another half-year probably had
passed, when this woman, in consequence of straining her eyes while sewing was
taken with conjunctivitis with severe photophobia. Besides, I noticed that the
left eyelid fell further over the bulb than the right. The pupil of this eye
was contracted and reached less to light. On enquiry she said she had often
noticed this before, but it had always passed off by itself as well as the
weakness of sight, which she ha sometimes noticed in this eye when working. As
for the rest, the sight of the other eye was very good, neither nearsighted nor
far-sighted. But in the twilight or under a clouded sky reading or sewing was
very difficult for her because a cloud was always hanging before the left eye.
The use of the ophthalmoscope was prevented by the pain which the light caused,
but I could observe no haziness of the media.
At this time it occurred to me
that this woman had lately lost her strength very much without, however, losing
flesh. Her declarations that she felt much worse in rest than when walking in
the open air, where she could forget her acknowledged loss of strength, until
she was obliged to go upstairs again, which for several years past had almost
put her out of breath, was a striking proof that there was increased need of
oxidation of the blood. On examination of the chest it was found that the
vesicular respiration in all moveable parts of the chest was more acute, and
that the sound on percussion had become very clear.
In the last sickness of this
woman I was led by a symptom in the nervous system to Argent. nit., namely, by
the affection of the left eye. But as the patient had for two days taken Arg.
nit. 2x, night and morning, she was taken with such a weakness in al her limbs
that she – and this is saying a great deal for her – was obliged to go to bed,
where she frequently fell into a stuporous condition with yawning and a cold
shudder over the whole body, and lost all her appetite. On the other hand, the
left eyelid was as much elevated again as the right; the pupils in both were
equally dilated, and the stitching pains in the left side of the chest had disappeared.
Without taking any more Arg. nit. all these symptoms had disappeared in two
days; the curative effects, however, remained, and simultaneously a marked
diminution of the cough had taken place although the sound had not changed
until now, after the lapse of three years, and the eruption râle could be only
partially heard on a very deep inspiration.
PAGE 97
Since that time this woman has
engaged in her occupation without interruption and considers herself and looks
perfectly well. This much is sure, that from her previous hydrogenoid
constitution a carbo-nitrogenoid constitution had developed in consequence of
medical treatment, and the latter is also in the way of improvement as the
pulse has even fallen to 70 beats.
The above was written three
years after the last dose of Arg. nit. had been given and three years later the
cure had remained permanent.
Case V
Duchenne’s Locomotor Ataxy. –
Argent. nit.
The president of country court,
45, came to me for a frequent cough which was often so violent that he lost his
breath and for difficulty of breathing after somewhat rapid walking by which
his face was congested. His face was uniformly pale with pale lips;
white-coated tongue; pulse 116; violent palpitation of the heart. Besides, he
complained also of increasing emaciation.
While auscultating him I
observed, to my no small surprise, that on every inspiration the upper part of
the abdominal wall drew in instead of expanding; while expiring on the other
hand, it expanded instead of receding. The number of respirations was 21. The
inspiration, which was at the same time short, warranted the conclusion that
there was a marked diminution of the lung capacity, yet the respiratory murmur
was to be heard in all parts of the lungs and no nutritive change in the organs
of the chest could be discovered. Only in the large bronchi was there a fine
crepitant mucous râle to be heard. An effort to breathe deeply took away, the
patient’s breath at once. All this not only warranted the certain diagnosis of
paralysis of the diaphragm, but also of a depressed innervation of the organs
of the chest. As I requested him now to walk with his eyes shut he was seized
with vertigo; he staggered sensibly in the third step; at the fourth he had to
open his eyes quickly in order to seize some object and keep himself up,
otherwise he would have fallen to the floor.
PAGE 98
This was quite unexpected by the
patient and alarmed him greatly, but I was able to assure him that he would be
perfectly cure. Thus the cause of all his troubles lay in the medulla
oblongata, the centre of co-ordination (Duchennes’ Locomotor ataxy).
Argent. nit. 2x, five drops
night and morning was ordered.
Surprising as it was, I did not
hear any more from this man for months when, quite unexpectedly, he came to me
again to request my advice for his wife. But how his appearance had changed!
His cheeks were fat and red, a perfectly healthy colour, with an evident
increase of his whole body; he spoke with such long breaths – a thing
impossible for him before – that i was not a little surprised by his silence
regarding his restoration to health. Asked how he had been since his last visit
he replied that after he had taken that little vial of drops all his former
complaints had left him. In confirmation he shut this eyes and walked up and
down the room without the least staggering.
Case VI
Hypochondriasis. Nux., Arg. nit.
An ecclesiastic, married, a man
of learning, sociable and highly esteemed in every respect, had been for five
years melancholy. He was then 51, and had suffered since his thirty-eighth year
from haemorrhoids which bled every four weeks almost regularly. At the same
time he was corpulent, yet on account of an intermittent fever which had been
removed by Quinine several years before, his liver seemed to have been still
more disturbed in its functions, since his skin from time to time had had a
yellowish tinge. Except for this he had never been ill, although he had had
measles and scarlatina as a child. He attributed his haemorrhoids to his
sedentary and studious mode of living. His melancholy he ascribed to an
undeserved slight which he had met with some five years before. This mental
depression soon increased until it became a fixed idea that he was neglected
and despised by his family. His calling became indifferent to him; he performed
his duties, as he said, only mechanically. This man, formerly corpulent, wasted
away from year to year; he became insensible to all social pleasures and lost
all desire for labour. Finally he gave himself up to the distressing idea that
all his undertakings would and must fail.
PAGE 99
When visiting me two years ago
he complained in addition to the above of constant drowsiness by day and
constant sleeplessness the whole night through; of weakness of memory, which
frequently did not allow him to find the right word, confusion of the head,
want of appetite, trembling of the limbs, which could also be seen; of
constipation, alternating with diarrhoea, while the previous haemorrhoidal
bleedings had ceased, although the tumours which remained annoyed him very
much. He complained moreover of lassitude and weariness of the forearms and
legs; and what alarmed him most were frequent congestion to the head, a
pulsation in various parts of the body, which appeared, however, as a jerking
of the muscles, and a constant chilliness. Against whatever I proposed to do
for him he had the queerest objections. His respirations were 20, pulse 80 to
84. I finally gave him Nux. 6, to be taken once a day till better.
For a whole year I heard nothing
more from him. He was sent to a water-cure and came back much more miserable
than he went in every respect. Afterwards I was informed that he could no
longer perform his duties, and for this reason a substitute had to be
appointed. He refused food because, as he said, a man who does not work should
not eat; however, when driven by hunger he sought in secret to procure food. He
spent the most of his time in bed, and when up it was necessary to use every
means to keep him from meeting anyone, for then he wept and assured everyone
that he was lost beyond hope for this world, and that no one could delude him
in that respect, and no one could reason him out of it. His weariness and
depression had also reached the highest point.
PAGE 100
I desired to examine him
personally. What an earth-coloured, emaciated, wretched form of melancholy he
presented! Stooping over he staggered when walking, despaired of help from
himself or others, constantly complained of vertigo, and was utterly bereft of
all will power. The ends of his fingers had become numb and his incessant
mental distress was accompanied with twenty-eight respirations per minute and a
pulse of eighty-eight. I had hardly exchanged a few words with him when he fell
asleep, but through the night he did not close an eye. Now he complained of
pains in the back too – drawings in the shoulders; he still had constipation
alternating with diarrhoea, chilliness, and cold hands and feet.
There were no sexual
complications as his parents were living and healthy, as well as were his
children. The source of the hypochondria in this case was, doubtless, the
result of primary carbonisation of the blood which, not removed but constantly
increasing, had already extended its reciprocal action on the brain and spinal
cord and that with an intensity that nothing more could be expected of Sulphur.
On the other hand, the phenomena were so similar to those of the proving of
Arg. nit., or rather of the Chloride of Silver, that four or five drops of the
2x were given night and morning. For three days nothing occurred that I could
attribute to the Arg. nit. The sleeplessness at night, his fixed ideas,
etceteras, pursued him unremittingly, and made him still more desponding,
because in the drowsiness during the day, which increased at the same time, he
thought he had to recognise an aggravation of his condition. On the night of
the sixth day he slept well, and instead of being sleepy the following day he
was in uncommonly good spirits; he talked much more on every subject that was
presented to him, and for the first time took part in a social evening
gathering of gentlemen. Now I thought it the proper time to suspend the use of
the Arg. nit., and the improvement progressed more rapidly than I had ever seen
it progress in similar cases without the use of the drug. After fourteen days –
fourteen days, I repeat – I sent him home cured. His friends could not contain
themselves for astonishment at his fine appearance and the complete cure of his
complaints. He resumed his duties without any ill effects and with complete
success.
PAGE 101
Case VII
Cardiac collapse, Cough, Ataxy.
– Acon., Puls.; Arg. nit.
The president of a court of
justice, whose father had died of tuberculosis, suffered from his youth up with
a cough with purulent expectoration. After a seton had been placed between the
fifth and sixth ribs of the left side, and which he has since worn, the cough
became more endurable and lost its malignant character. Still he daily coughed
when lying down and on wakening; and on ascending long stairs he had to rest
often or he lost his breath.
In his thirty-sixth year,
however, his wife observed that he always avoided walking in certain streets.
Questioned as to the reason of this he replied that the sight of high houses
always made him dizzy and caused him to stagger; it seemed to him as if the
houses on both sides would approach and crush him. This vertigo disappeared at
once as soon as he saw no more high houses, and it was noticed on no other
occasion.
After the lapse of several years
he was taken with pneumonia, during which much blood was taken from him. He
recovered very slowly and hen, after two months, he finally endeavoured to
leave his bed he as seized, with dizziness which he could not overcome. He was finally
taken to the baths at Kreuth and at length returned to his calling. Yet, in
exposure to any exhausting labour he always had a pain which affected the whole
head and which made the letters run into one another when reading.
When 56 years old he came under
my treatment for the cough which had never left him since that attack of
pneumonia. He was much emaciated, looked pale, and had the sunken features of
an old man. In the upper parts of both lungs there were now large, now small
vesicular râles; on the left lower portion none but vesicular and bronchial,
and the irritation to cough lay behind the middle of the sternum.
PAGE 102
Aconite relieved him of his
cough by day and by night so promptly compared with his previous allopathic
drugs that he became henceforth a faithful adherent of the system.
On examining the chest I found
stenosis and insufficiency of the bicuspid valves, and since the cough was
confined again to morning and evening I ordered him to take Sulphur
After this his wife requested me
to examine him again. He had been obliged to work very hard and she was now
alarmed to see that he stood and walked unsteadily again, as often as he
thought himself unobserved. Before I had a chance to propose to him an
examination, he sent to me a few days later, and his servant said I must make
haste as he had left his master pale, breathing heavily and blue in the face as
if he were dying. In this condition I found him, lying on a sofa and without
any pulse, hardly able to speak, which I also forbade him after he had assured
me that he did not know of any reason for this distressing condition.
Pulsatilla 3 was given. He rallied sensibly from second; his pulse, which I had
known before to be irregular, returned, and after a few days’ rest he was
convalescent from a condition which I could only explain as caused by a
disturbance in the tract of the Vagus and Sympatheticus, which must have been
occasioned by a diminished process of oxidation in the blood continuing for so
many years. A long respite followed again and he always relieved himself with
Aconite and Pulsatilla.
He finally came to me, however,
unbeknown to his wife, and complained that he could only pursue his calling by
the greatest effort of will, and that he would be compelled to ask for a
vacation because of incessant vertigo pursued him, compelling him always to go
close to houses in order to have something to hold on to. Moreover, the little
and ring fingers of the left hand had become insensible. He noticed also in the
whole left side of the body an indescribable weakness.
PAGE 103
Now according to what principle
was this man to be treated, or was he to be held as beyond treatment? Did he
belong to the category of Tuberculosis, of Ataxy, or of diseases of the heart
or brain, or where, in the drug-provings even could there be found the truly
indicated remedy without considering the concomitant conditions which were also
presented therein?
After the patient had taken Arg.
nit. 2x every two hours for five days he was relieved of the affections of the
brain and spinal marrow which had lately renewed their attacks and more
violently than ever. Even on the very firs day he was able to go to his office
without fear of staggering and stumbling like a drunken man. Two weeks later he
had lost also the insensibility of the left hand. His complaints of weakness of
the left half of the body were heard no more and his respiration was again as
free as it ever had been.
Case VIII
Haemoptysis in Hydrogenoid.
Constitution changed to Carbo-nitrogenoid under treatment. – Nux., Nat. sulph.,
etc., finally Argent. nit.
A merchant, 37, his parents
still living and healthy, had taken part, sound and healthy, in the
revolutionary war in Baden as a common cannonier without any bodily injury.
When seven years old he had had fever and ague; in his twentieth year he had
gonorrhoea, which was suppressed by injections. Apart from these he had never
been ill.
In April, 1860, when he was 37,
while stooping to part his dog, he was surprised, being then in the best of
health, by suddenly coughing up blood, and within the course of half an hour be
coughed up a wash-basin full. He had, indeed, for several years past, coughed
somewhat every morning without taking any notice of it. This cough, however,
with bloody expectoration, had now been diagnosed as haemorrhoidal congestion
and treated with leeches ad anum and cathartics, although the patient assured
his physician that he has never suffered from piles.
On account of the pulmonary
haemorrhage itself, which lasted three days, common salt was ordered internally
and those purgatives were given daily in the form of pills to force the
evacuations which, however, had never been wanting. Four weeks later haemorrhage
recurred, and now for half a year it returned almost every four weeks,
sometimes lasting only half a day, sometimes two or three days. After this the
haemorrhage intermitted for four months.
PAGE 104
While taking a walk in February,
1861, he suddenly had another violent attack of haemorrhage and, to the
treatments of this attack I was called in.
Of tuberculosis of the lungs or
of piles there was no trace whatever. The man had a yellow complexion, was
emaciated, very weak and had no appetite since he began taking the pills. Sleep
good; pulse 90; respirations 35; stitching pain in the region of the fifth rib
on the left side. In the same place there was a fine crepitant râle occupying
the space of a florin. He was ordered Acon.
The next day Acon. and Ars. were
given in hourly alternation and it was two days before all blood had
disappeared from the expectorations. Now oedema of the feet ensued.
Thus far the haemorrhages had
always taken place during a longer spell of damp weather, and his condition is
even more acutely aggravated when there is a cold rain.
On the sixth day, on account of
the loss of blood China 3 was given every two hours; and nourishing food, since
his appetite was restored, with wine or wine and seltzer water. The pulse
remained the same; the respirations fell to 28. But on the least mental emotion
the pulse rose and palpitation of the heart ensued.
The patient assured me that
conformably with his excitable temperament his pulse had always been very
rapid; that he had always been liable to attacks of palpitation, and that for
many years he had been careful not to run upstairs so rapidly as he had been
previously accustomed to do. His bowels moved generally every day, sometimes
not so often, but always of themselves. As his appetite increased the patient
gained strength very rapidly, but on account of his decided hydrogenoid
constitution it was necessary that he should take every day from this time
forth one dose of Nux. 3 and three or four doses of Nat. sulph. The oedema of
the feet disappeared after ten days.
PAGE 105
On May 27th, another haemorrhage
occurred after a fit of passion; Acon. and Arn. prescribed as above. The
haemorrhage stopped on the second day, and from this time forth I gave Nix. and
Nat. sulph. daily. Rapid improvement followed and the remedies were
intermitted. The patient spent every evening in the summer in his usual society
whose members could not sufficiently wonder at his healthy appearance after
what he had gone through.
On November 10th, after a
business journey, haemorrhage again occurred, but lasted only half-a-day and
ceased of itself. Nux. and Nat. sulph. were taken as ordered above on the
patient’s own responsibility.
On January 27th, 1862, after
violent excitement, a new haemorrhage occurred, but lasted only half an hour.
Notwithstanding these repeated
attacks the patient had enjoyed remarkably good health, and congratulated
himself on his fine fresh appearance and good spirits. The beat of the heart,
however, always kept up to 85 or 90.
In September, on a business
journey, he had an attack of intermittent fever with pulmonary haemorrhage.
Treated by a homoeopathic physician wit Ipec., Quinine and Acon. the patient
returned home without loss of strength. Nux. and Nat. sulph. to the taken again
for eight days and omitted for eight days, and so on.
After January, 1863 no further
medicine was given since auscultation and percussion could not detect the
slightest abnormality; the patient felt well in every respect and began to grow
corpulent.
On June 6th, after a cold during
a profuse sweat on a hot summer evening, he had a chill. He slept well,
however, through the night, but woke in the morning with violent febrile heat,
with headache, stitching pains behind the fifth rib where the stitches had also
been observed during the attacks of bleeding. Every breath, and still more
every cough, although he coughed seldom, caused a severe stitch in the place,
and the patient hence expected every moment a fresh haemorrhage. Thus I found
him in the morning, bathed in sweat; with face reddened; pulse 120;
respirations 40; tongue with a heavy yellowish-white coating; much thirst; disgust
for all food; was only able to take milk as everything else was vomited up
again; sputa consisting of foamy blood; crepitating tattling on the seat of the
pain; the percussion note scarcely perceptibly muffled.
PAGE 106
The previous attacks of haemorrhage
had clearly arisen from a hydrogenoid soil; hence I did not hesitate a moment
to give Iod. 3 every half-hour till the stitching pains remitted and after that
every hour.
Up to the next morning there had
been no change at all. This striking negative result and the anxiety of the
patient to keep himself thoroughly covered since a chill crept over his whole
body on the slightest movement, though the room was warm – this in connection
with the increased difficulty of breathing, induced me to give Phos 3 every
hour.
Up to the third day, contrary to
all expectoration there was hardly a perceptible improvement. The cough has
assumed even a dry spasmodic character, which I had to ascribed to the
influence of the Phos. sputa were rust-coloured, containing air bubbles of
large size, and were scanty. Pulse, respiration, temperature of the skin and
perspiration and the results of auscultation and percussion were as on the
first day.
To be frank, I did not known any
longer what to think of the case, so I gave Sacch lact. in order to gain and
undisturbed observation. And I opened the windows since the patient very
earnestly longed for fresh air.
June 11th. The same state of
affairs and sensible emaciation and wasting of strength. The sputa had become
yellow, but certainly not coloured with “bile-pigment” (!). China 3 every two
hours was ordered.
June 13th. Less pain, at least,
but permanent fever. The patient spoke confusedly and did not know his wife;
slept no more; when he talked his speech was broken and he gasped for breath
after every word. Phos. acid 6 every two hours given.
PAGE 107
June 15th. The fine crepitant
râle became coarse and extended higher. Sputa puriform.
June 19th. Some relief as the
cough was less frequent and the respiration more quiet. The sensorium became
free again. Up to this time milk and sugar water only were desired. To the
former Seltzer water was now added.
The effect of medical treatment
amounted to just about nothing; nevertheless the Phos. ac. was continued.
June 21st. The appetite was
somewhat improved and now and then mucilaginous broth was taken. The urine
constantly presented the usual sediment of uric acid, and the stools occurred
at first daily; later not so often, though nothing was given on that account.
The strength seemed to increase. No further remedies.
June 25th. Irresistible
inclination to get out of bed and sit by the open window. Now in the armchair –
now in bed again. The coarse crepitant râle, the puriform expectoration, the
cough, the fever, the pain on the side were still present though in a less
degree.
June 27th. In addition to the
other symptoms he was still hoarse. On the other hand he was able to remain
somewhat longer out of bed, though it was impossible for him to walk without
holding on to something with both hands; he was altogether too weak to stand
erect. Every time he sat by the window he felt much refreshed.
June 30th. The fever is sensibly
consuming his strength; his tongue has a yellowish-white coat, although he has
more appetite; the urine full of uric acid; pains in the calves often torment
him the whole night, and during the day he is constantly tormented with
formication in the arms and legs. The pains in the left side of the chest still
continue, only they are somewhat deeper and are not any longer increased by
coughing; oedema of both feet. My fear that I should lose this patient by
reason of his hectic fever seemed justified; yet I auscultated him again and
found that the coarse crepitant râle was limited to the same spot behind the
fifth rib, but above, was more extensive, while the pain now was pointed out as
corresponding to the sixth rib, which also was painful on being pressed upon as
far as towards the spinal column.
PAGE 108
I should have been very happy if
I could have obtained an anchor, a compass and a helm from the physiological
school, since this patent had become a convert to homoeopathy under my
treatment. But the physiological school had neither for this case, nor for an
infinitude of other cases, any pilot.
I had nearly lost this man from
disregarding the change which had taken place in the state of his body by
reason of the treatment followed for so long a time. First, the circumstance
that the pains in the side now correspond to the sixth rib and no longer to the
fifth; that the patient now, on being questioned, declared the present pain to
be quite different from what it was at first; moreover, his longing for fresh
air, which was never so marked before, the indifference to moist or damp
weather, observable even before his last illness; his corpulence which of late
had sensibly increased again. All these went to prove that the hydroscopic
condition of his blood was removed; that, on the contrary, its oxidation, even
before this last illness was depressed, and during the illness so sank that the
spinal cord began to suffer under it, which condition was clearly connected
with this inter-costal neuralgia, the cramp in the calves, and the formication.
Argent nit. 2x was now given
every two hours and the course of the disease after its exhibition is extremely
interesting and to the patient himself appeared really mysterious.
Although I never allow a remedy
to be taken during the night, very rare cases excepted, and did not in this
case, yet the patient declared on the very next day that the pains about the
sixth rib, which had affected him so seriously, had become so trifling that
they hardly troubled him at all; also that he had not for many weeks slept so
long or so quietly, and had more appetite again. But the most remarkable thing
was the daily decreasing crepitant râle and the corresponding decrease of the
cough and the purulent expectoration. The patient took a new lease of life, and
after taking the remedy for seven day the pulse had sunk to 80 and Argent. nit.
was laid aside.
The convalescence from this
all-but-fatal illness progressed with great strides, and by the end of August
this man was perfectly cured. He had regained this previous fresh complexion,
his good spirits and his mental and bodily strength, returned to his occupation
and remained well.
PAGE 109
Case IX
Enuresis with Rapid Pulse. Quick
Pulse and Need of Air. – Arg. nit.
A young man, 18, of sound
parents, had suffered from his youth with incontinence of urine, and after all
sorts of tortures had to leave the institution in which he had been a pupil for
four years, being declared incurable. In his childhood he had often had swollen
glands. Now he is large, powerfully built and I observed nothing abnormal about
him except that his pupils were large and that the beat of the heart was
somewhat more frequent than normal and rather weak. He had never suffered from
worms and there was nothing peculiar about the constituents of the urine.
Was the indication in this case
to direct the patient to retain his urine during the day as long as possible?
Or, should I rather give him Bell., Puls., China, Causticum, Sepia or Sulphur,
and on what grounds?
I gave him instead Argent. nit.
2x, night and morning, for six days, and then stopped it. From the first day of
taking the medicine he did not wet the bed for a period of six weeks. He had
then resumed his studies and was obliged to pass the entire day within four
walls. It was certainly and unexpected event that after this day he should wet
the bed again. Arg. nit. was again ordered and the patient was directed to walk
in the open air at least an hour every day, whatever the weather might be.
After ten days the incontinence ceased and returned no more.
Case X
Malarial-ataxy. – Arg. nit.
A large, powerfully-built
merchant, 41, always healthy, had two years before, while travelling,
contracted intermittent fever which was suppressed with large doses of Quinine.
Since then he had never been well, whilst previously he had never been ill, and
always had a blooming appearance. A year ago he was taken with gastric fever
which had become typhus, as his physician told him. There was no
unconsciousness, however, and no hallucinations, no diarrhoea or chest trouble,
only constant pans in all parts of the head, especially the occiput, which
deprived him of sleep, and every evening he had fever.
PAGE 110
These pains in the head finally
extended to the eyes and the lower jaw. Itching pustules also formed over the
left shin bone, one of which developed into an ulcer.
After six weeks of allopathic
treatment, during which he constantly got worse, lost flesh and all his
appetite, he was so much unstrung and irritated that, without the knowledge of
his physician, he sprang up to get into the open air.
Although punished for this by
utter prostration of strength, so that he had to ride home, he had to his great
delight the first good night’s sleep and thereupon more appetite, and that
suggested to him the idea that he was not being managed well.
When he came under my care this
man, once so corpulent, was to emaciated that his clothes hung on him as on a
clothes-horse. At the same time his face as sunken, colourless, and he
complained of constant boring headache, and photophobia and weakness of sight,
which alone would have prevented his writing his name legibly, had he not been
also hindered therefrom by trembling of the hands. Furthermore, he reeled so
from vertigo at night and when his eyes were closed that he always had to hold
on to something. To fix his thoughts on anything, or to give his business any
consideration was impossible; on attempting it, it immediately got dark before
his eyes and the headache increased. Moreover he could not separate his jaws
wide enough to admit more than a quill. That prevented hi speaking and he could
only take fluid food. But what distressed him most was a disgusting odour from
the little ulcers with which the inner nose as lined, fearing as he did that
those around might be annoyed by it, which, however, was not the cases. The
stools were regular, the voice hoarse; no change could be discovered in the
chest organs by auscultation or percussion; yet the impulse of the heart was
very strong and audible over the whole thorax; pulse 98. The fundus of the eyes
was obscured and the vessels could not be seen. Sometimes there was
haemorrhoidal flow but no piles. The fever in the evening was no longer very
perceptible, but it seemed to him that he had a fever in his sleep. Since he
was taken ill he had never been able to go upstairs without increase of the
difficulty of breathing.
PAGE 111
Whoever has read Dr. Eisenmann’s
work on Locomotor Ataxy will have no difficulty in placing this case under that
head, but where, from that work, could a remedy be found?
This patient also after the
lapse of two months was relived of all his sufferings by the use of Arg. nit.
He took it for eight days night and morning and then omitted it for eight days,
and so on, without the appearance of any drug symptom. After the sight was
restored, the nose cured and the trembling of the hands, after it became easier
for him to go upstairs, there still remained an insufficient movement of the
lower jaw, and I hoped that the secondary effect of the remedy, or rather
allowing it to complete its effect would remove this also. It continued,
however, for half a year longer, and the staggering when the eyes were closed
was still present though in a much less degree. Arg. nit. was now repeated.
After eight days there was marked improvement. No further remedy was given and
after two months the cure was complete.
This was clearly a case of
malaria-ataxy, the malaria being the primary cause. We homoeopaths have not
only Arg. nit., Arsen. and Iod. as problematical remedies for locomotor-ataxy,
but as tried remedies Arg. nit; (or, rather Arg. mur.), Am. mur., Sul., Arsen.,
Bell., Cyclamen, Mangan. acet., Gratiola, Phos., and Phos. ac.
Case XI
Amblyopia, Blood-rushes, Ataxia.
Aggravation and then cure with Arg. nit.
A near-sighted Treasury officer,
who wears concave glasses, 51 years of age, had cholera in Munich and
subsequently abdominal typhus (enteric). During the past winter he suffered
from facial neuralgia and swelling of the bones of the right foot. At the same
time an herpetic eruption was observed on the occiput. The more this increased
the less were the pains in the face, and in the spring they ceased entirely.
The eruption also gradually disappeared. On the other hand, in the month of
March there was determination of blood to the head, which was treated with
Sulph. and did not return. During a leave of absence, however, these congestion
returned in a very distressing manner. In the course of an hour they were
repeated four or five times after they had always ceased spontaneously. He then
suddenly felt how the blood pressed from the heart to the head, which became
blood-red the colour extending to behind the ears, even. Gradually the blood
ebbed again and sweat appeared on the head. These rushes of blood acted
injuriously on the eyes. Since their occurrence objects appeared as if
enveloped in a mist; sometimes they seemed double. After a forced walk these
rushes of blood came also at night; there was a stitching pain then from the
right into the left ear, as if from a thrust with a dagger. In the dark he cannot
walk without reeling and laying hold of whatever he can.
PAGE 112
Nausea now followed these
repeated attack, and, called to see him once at night in such an attack, I gave
him Bell. 3 the next morning. This was followed by confusion of the head, which
was a sign that Bell; was not indicated. He can read with his glasses only No.
13 of Jaeger’s test letters; the fundus of the eye is injected; the large
blood-vessels are indistinct.
Reviewing this case, I must
acknowledge that if in Therapeutics there was not a synthesis on the basis of
natural laws, a mere analytical comparison between these groups of symptoms and
the provings without a consideration of accompanying circumstances could hardly
lead to an indication which could foresee the result.
In the group of symptoms just
laid down the point of departure of the disease is a more or less diminished
influence of oxygen upon the organism.
The patient now received Arg.
nit. 2x, morning and evening; but after the first day not only was there no
improvement but his power of vision was so greatly disturbed that he greatly
feared he would lose his sight altogether. He could only read Jaeger 17, and
this alarmed even me not a little. Sacch. Lact. was now ordered. A week later
he was able to read No. 13 again. Thus the aggravation from Arg. nit. subsided
spontaneously without antidoting. Eight days afterwards the condition was as at
first. I now ordered Arg. nit. 10x morning and evening.
PAGE 113
Four days later he returned with
the assurance that he could now see better than ever before and could actually
read with his glasses, Jaeger No. 4 without difficulty, although with the
ophthalmoscope I could discover no change in the fundus oculi.
On the other land he had felt
the good effect of these drops instantly; he thought he could distinctly feel
the blood settling down from his head. I now directed him to set the drops
aside, and some weeks later he called again to say that the congestions, which
he noticed for a few days longer, had now entirely ceased and he considered
himself quite cured.
The forms as well as the number
of diseases in which Arg. nit. has accomplished a cure for me are far greater
than in the cases here recorded. The forms extend to most of the diseases
included in this bodily constitution and even to special diseases of adults and
children, including one form of hydrocephalus. The sphere of Argent. nit. is so
comprehensive because it stands, like Manganum, midway between Sycosis and
Psora, and s all the more valuable because complications of these two
constitutional characters are not infrequent.
PAGE 114
Conclusion
Von Grauvogl’s book contains
many other precious gems of practical experience which might be included in
this volume, but as they have no direct bearing on the subject of the
Constitutions I prefer to let the record of the latter stand out in their
clearness unmixed with other topics. Without having encountered many cases as
clearly defined as those of Grauvogl and Bojanus, I can say that very few days
of practice pass over me without my making some use of the doctrine of
Constitutions as here laid down.
According to Grauvogl the human
race can be divided into two sections – the born analysers, and the born
synthetisers. But the Homoeopath should be born both; and if he is only one
should make himself the other, whichever he is. It seems to me that the School
of Kent have reached the limits of possibility in analysis in the tracking down
and matching of individual symptoms. This has been made possible mainly through
the monumental work of Dr. Kent himself in his great Repertory. But the no less
important synthetic work of putting the items of drug symptoms together and
finding the connecting thread which runs through them and binds them into an
organic whole must not be neglected. Hahnemann himself saw the necessity of
this, and the outcome of his research in this direction was his work on “The
Chronic Diseases”.
Von Grauvogl followed
Hahnemann’s lead, but struck out an original line of his own. It is one of the
grand traits of Homoeopathy that it fetters no man’s mind. Like Hahnemann
himself Grauvogl was an expert chemist and could follow the chemical changes
taking place in the blood and tissues. This led him to find new threads and new
methods of finding the generalities amidst the particulars. It is not too much
to say that his discovery has been more fruitful of result from the
prescribers’ point of view than any of the others.
PAGE 115
Since the day of Hahnemann and
Grauvogl the bulk of the Materia Medica has increased enormously and the
prescribers’ field of choice has increased in proportion. Hence the added
necessity of making all possible use of such general indications as are
available. As a matter of fact every practitioner does this more or less instinctively,
keeping of course, the Materia Medica and Repertory at hand for confirmation of
the indications when needed.
That there are various avenues
by which the same remedy may be found by different men and different systems is
a saving clause in medical practice. But by whatever avenue a medicine is
reached, it will act in its own way regardless of the man who prescribes, it.
The remedies themselves care nothing for systems and theories – they do their
own work when brought in contact with it, whether they rare given by a
Hahnemann, a Schüssler, Rademacher, or a Grauvogl.
In my own practice I invariably
put to my own patients the same questions that Grauvogl did, and this at once
sorts them into sections and narrows the choice of remedies. I also follow the
Paracelsic maxim and find, if I can, the beginning. If I learn that a patient
has never been the same since an attack of influenza either of recent or
ancient date, I am fairly certain that a course of the Tuberculinum of Koch
will be required. If, again, there is a history of vaccination, “successful” or
otherwise, in the case, Thuja, Vaccininum and Variolinum are at once visible in
the field. So that there are many other constitutional indications to be found
independently of those supplied by Grauvogl. These every practitioner will be
able to find for himself.
That the names of diseases are
mere abstractions Hahnemann and Grauvogl were constantly insisting. In this
they again followed Paracelsus’ lead. According to him diseases or morbid
states should be called by the names of their remedies. As the Homoeopath says
“this is a Lycopodium case, and that other a Sulphur case”, Paracelsus writes :
“If we say this disease is a disease of Pulegium, this one of Melissa, that one
of Sabina, then we have a certain cure from the name. A natural and true
physician says that this is a Morbus Terebinthinus, that is a Morbus
Helleborius, etc.; not that this is Rheuma, Coryza, Catarrh. These latter names
do not proceed from curative knowledge; for similars must be compared with
similars in names; from this comparison proceed the cues”.
PAGE 116
The “Pocket-Book” of von
Boenninghausen is the most successful work we have in the way of repertorising
the generalities of the Materia Medica, and its author has laid Homoeopathy
under an obligation no less great than that of Grauvogl. It is all in the
direction of unifying the great mass of individual symptoms. A further great
aid to simplicity in prescribing is that advocated by Dr. Lippe and his
friends. Out of the characteristic symptoms of the remedies they marked out
those which they named “Key-Note symptoms”. Indeed, some symptoms or conditions
of symptoms are so characteristic of certain remedies that when one of them
appears in a patient it is almost certain that other symptoms of that remedy
will be found in the patient too.
Paracelsus wrote : “That which
is perceptible to the senses may be seen by everybody who is not a physician;
but a physician should be able to see things that not everybody can see. There
are natural physicians and there are artificially made physicians. The former
see thins which the latter cannot see, but the others dispute the existence of
such things because they cannot see them. They see the exterior of things, but
the true physicians see the interior. The inner man is the substantial reality;
while the outer one is only an apparition; and therefor the true physician sees
the real man and the quack sees only an illusion”.
Said J.C. Burnett : “I don’t look where you look; I let
my imaginations play about a case”. It was by such “looking” and such play of
his imagination that Burnett was enabled to see a nexus between the ringworm
parasite and the bacillus of tuberculosis, and which further led him to cure
many cases of ringworm with Bacillinum or Tuberculinum, which in his day was
not to be found in Materia Medica or Repertory.
William Blake, who was no
physician, but who was a Seer, wrote : “My business is not to argue and
compare; my business is to create”. And again : “”I must create a system for
myself, or else be the salve of some other man’s”. “Non sit alterius qui suus
esse potest” “Let him who has power to be his own not be the property of any
other man” – is Paracelsus’ way of saying the same thing. It is the glory of
Homoeopathy that it permits everyone to follow his own genius in perfect
freedom without fettering him to any man’s dictum or authority, be it
Hippocrates’, Hahnemann’s, Grauvogl’s, Burnett’s, or Kent’s. In the last resort
every physician must and does create his own system from his own experience,
and from such experiences of others as he is able to digest and make his own.
PAGE 117
Other men’s works provide the
nutriment required by the beginner for forming his own mental organism before
it can be hatched out of his own experiences. Those who can put their
experiences into such shape that others can appropriate their teaching and make
it live again, are the greatest benefactors to medical science and art.
It has been my aim in compilling
this volume to put the work of one of the chief of these benefactors into such
apprehensible shape that all may partake of the feast he has provided and make
so much of it as their own genius can absorb a living part of themselves.