CONGENITAL MALFORMATIONS



Now, although I felt the idea of trying to prevent hare-lip with the help of specificity of seat in the ordinary homoeopathic sense unworkable, still this lay in the nature of the case rather than in the nature of the thing generally. Thus in those liable to beget offspring with defects or deformities, or displacements of organs, or parts to which we have approved remedies with specific affinities for such organs or parts, we might, and undoubtedly should, find it of eminent service, and also of the careful application of the homoeopathic law of similars; also of the tripartite pathology of Hahnemann; and of the constitutional states of Grauvogl, and, perhaps, even of the Remedia universalia of Rademacher. *Remedium universale is not a would-be panacea or cure-all, but one that hypothetically affects the universe of the microcosm, i.e., not an organ.

Derived from the first visceral arch, in which an angular bends appears; the part above this bend being converted into the superior maxillary mass, and that below it into the inferior maxillary mass, and that below it into the inferior maxillary apparatus.

The superior maxillary mass, in its growth, approaches the frontal process, and unites with it; a cavity being left between that process and the two superior maxillary masses, which becomes the nasal cavity. By the union of the superior maxillary masses (the superior maxilla and palate bone) of opposite sides beneath this cavity, the separation of the nose from the mouth by the palate is effected.

The mode of development of the face affords an explanation of the abnormal cleft-palate, and the congenital cleft between the upper maxillary and the intermaxillary bones and of those congenital fissures which pass between the intermaxillary and upper jaw, as far upwards as the orbital cavity. Congenital clefts of this kind are thus the results of an arrest of development occurring during the primitive condition of the parts.

We may, therefore, infer that cleft-palate is due to lack of a due supply of formative material; the superior maxillary masses ossify indeed, but fail to unite in the median lines. If so it will follow that if the requisite amount of formative matter be supplied soon enough to the maternal blood, it will be given off to the foetus, and tissued osseous union will take place, and deformity will be prevented.

But the skeleton may unite in the middle, and yet the soft parts fail to do so; and when this occurs with those of the superior maxilla, the deformity known as hare-lip is the result.

We may regard the basis of the upper lip structure as already differentiated into connective tissue, which is indeed the stroma of the whole body, and all of its organs. When, therefore, the soft parts fail to unite in the median line of the upper lip, and we get the ugly defect known as hare-lip, we may conclude that the development became arrested from a lack of one of its constituents in development or functional power.

All things considered, I concluded it was, in this case, lack of lime-life.

Then the next point was–which salt of lime? Here the psoric constitution of the mother pointed to Sulphur.

My conception was not that there was an actual lack of lime as such, but rather a lack of assimilative or developmental power of the lime-function in the sense of Moleschott and of Schussler, and that struma or psora (== morbid x) was the hindering agent.

I therefore decided on Calcarea sulphurica, and believing it was quality that was required, and not quantity, I determined on the sixth centesimal trituration.

This is how I diagnosed, theoretically, a remedy for this case of presumptive defective formation, and this remedy I made up my mind to give if the lady should come under my care.

A little time elapsed, and the husband appeared to inform me that his wife was believed to be enciente. Calcarea sulphurica, 6th trituration, one grain night and morning, was prescribed. The lady continued to take it till the end of the seventh month of pregnancy, and during the last two months she took Lithium carbonicum, and at full term she gave birth to a healthy and perfect child.

In due course a second pregnancy took place. The same course of treatment was adopted, and with the same happy result–viz., a perfect child.

Since this time I have kept the subject of the intra-uterine medicinal treatment of the human foetus before my mind; but my experience here has since been for the purpose of preventing, respectively eradicating, constitutional taints and hereditary proclivities. Cases other than those two, for the prevention of defect or deformity, have not hitherto come under my observation.

But this further experience of mine I will refer to again, as an interesting paper, published in the Practitioner for December, 1878, by Dr. Thomas P. Tuckey, of Country Cork, Ireland, here claims attention. The paper is entitled, “On the Preventive Treatment of Cleft-palate and Hare-lip and some further Remarks on the Relation of the Ovaries to the Sex of the child.”

Our author tells us that his attention was directed some years ago to the remarkable success which has attended the Dublin Zoological Society in the breeding of lions, and the great immunity which animals born in their gardens, in the Phoenix Gardens, enjoy from various disorders and deformities to which the lion bred in a state of subjection is liable. The most remarkable of these diseases is cleft-palate, which lions in a captive state are very apt to have. Dr. Tuckey believes it was the Rev. Professor Haughton, when speaking before some public assembly, who drew attention to this fact and stated that it was his opinion that the cause of the lions in the Dublin Gardens being born so unblemished was giving the mothers bones which they could crush. This fact very much impressed Dr. Tuckey, as he happened to have under observation a family of several children who were all, both male and female, subject to hare- lips, several of which cases were complicated with cleft-palate, he determined to speak to the mother, who was in poor circumstances, and ask her to let him know the next time she was in the family-way, that he might give her a medicine which would prevent her next child having the same deformity as the others. The poor woman was heart-broken, taking her children here and there to be operated upon, and quite jumped at the idea, and promised faithfully to come and report herself the moment she believed herself to be enciente.

This is the woman’s family history :

Mrs. H., aged thirty-five, mother of six children.

Every one of her children have had hare-lips, two have also had cleft-palate. The disease appeared not to be hereditary, and she could not call to mind any of her family, or of her husband’s family, who have had hare-lips. Is a fine strong woman, but has fearfully crooked eyes; no other deformity. Has always had good health. Her husband, small, but strong and healthy, never has had any diseases, while she has been married to him. He and she have both lived all their lives in the country. He is sober, and has always been so. Her first child had simple hare-lip; no cleft in palate; does not remember getting any frights when carrying her children.

A pregnancy occurred; Mrs. H. presented herself, and the doctor prescribed the following mixture :

Rx. Calcis phos. 3j. grs. 20.

Calcis carb. 3j.

Bicarb. magnes.

Chlorid. sodii.

Sodae. phosph. aa -) ss. M.

To be added to an 88 oz. mixture composed of Gelatine, Gum arabic, Syrup of ginger, and Cinnamon water; 1 drachm three times daily.

As clefts in the palate and lip are said to be due to arrest of development prior to the end of the third month, Mrs. H. was at once put on this mixture, which is intended to represent a very rough analysis of the constituents of bone. In any future cases Dr. T. thinks he would grind up the bones of the head of some animal, and give some of the powder instead of the above elaborately constructed mixture. The essential parts of this mixture are clearly the Lime, Phosphorus, and Magnesia. The little poly-pharmaceutical performance of adding Gelatine, Gumarabic, Syrup of ginger, and Cinnamon water is not a little amusing.

But to return. The woman took the mixture regularly until the fourth month; she went her full time, and was delivered of a girl, without a trace of deformity about her lips or palate; the child was healthy and strong.

[This mixture was a strong alkaline one, and prevented acidity and facilitated child development.– T. C. D.]

Hearing of this case, a Mrs. L. came to seek Dr. Tuckey’s advice. She was the mother of eight children, most of whom had cleft-palate and hare-lips; in four of them the hare-lip was double, and more shocking objects of deformity he had never seen. One boy was perfectly repulsive. The woman believed herself pregnant, and was at once put on the mixture. She went her full time, bore a girl without hare-lip, indeed, but who evidently had had one in utero, for the lip, though united, was united crookedly, and one side was puckered up, as if by a slight and narrow burn.

Thomas C. Duncan
Thomas C.Duncan, M.D., Ph.D., LL.D. Consulting Physician to the Chicago Foundlings' Home.
Editor of The United States Medical Investigator. Member of the Chicago Paedological Society. First President of the American Paedological Society Author of: Diseases of infants and children, with their homoeopathic treatment. Published 1878 and Hand book on the diseases of the heart and their homeopathic treatment. by Thomas C. Duncan, M.D. Published 1898