CONGENITAL MALFORMATIONS



This is, truly, a most remarkable and interesting case.

I must demur to the statement that the arrest of development occurring before a certain period necessarily involves the conclusion that treatment in the latter months of gestation would be useless. This is a pure assumption, and based on normal observations. Here we have to do with arrested and therefore retarded growth, and hence the nutritional or medicinal treatment should not only be begun early, but continued to the end; and one begun late would still be hopeful of obtaining amelioration, if not of complete normality.

Again, there is an objection to the use of the bone, simply as the lips have not the same constituents as the bones, and in the same proportions; so if we are to give pulverized heads we must give the lips too.

But we, happily, need neither one nor the other; neither do we need any bulky, cunningly-devised mixture, with nasty or nice additions, to mystify, and obscure, and render our own observations open to objections.

Pure clinical experiment must be with one remedy at a time to be convulsive.

Thus, I may object to Dr. Tuckey’s proposition that the phosphates did the work in his cases, on the ground that the tincture of ginger acted as a stomachic, and strengthened his patient’s digestions, so that they assimilated more food, and thus were the defects prevented. Another might attribute it to the gelatine; a third to the alcohol, a fourth to the cinnamon.

Then this polypharmacy prevents individualizing, which is the soul of all true progress in scientific medicine.

I was once struck with the extreme beauty of a lady’s children, both parents being rather plain, and found that she had been in the habit of using a mixture of phosphorus, iron, and sherry during gestation to keep her strength up. Her own health was seriously injured by it.

I think it will be conceded that it is at least highly probable that the preventive treatment of congenital deformities and defects may be undertaken with good chances of success, and I venture to submit that this corner of the field of practical medicine is well worthy the attention and skill of all physicians, and also of all well-wishers of the race, lay as well as medical.

It will be of surpassing interest to the individuals and families more immediately interested, through having undesirable family proclivities.

There is here great scope for the tissue remedies, especially when dynamized, as it is likely to be qualitatively changed nutritive building material that is required.

No doubt the various cases of congenital defect and deformity differ essentially in their natures, and will require accordingly different remedial or preventive treatment.

This immense field lies fallow ready for the tilling talents of willing workers.

As soon as this is undertaken, facts will multiply, and reliable data will be at hand to guide us.

To draw a line of demarcation between the nutritional and medicinal treatment is not now possible. Undoubtedly some cases will require nutritional treatment solely; others will require medicinal treatment directed to the mother’s constitutional crasis; in others, again, a debilitated generative sphere may claim attention. Or a presumable taint in the marital product may call for the principal intra-uterine therapeutic endeavors.

Here I may narrate the following observation : A lady patient of mine was extremely fond of liver, during one of her pregnancies; at least once a week she would partake copiously of it–pregnancy fads are as old as the world. This lady was delivered of a very fine child that had extensive pigmentation of the forehead, such as we are wont to see in some ladies during gestation. This brown discoloration gradually disappeared from the baby’s forehead in about four weeks. The mother’s skin was also in parts very deeply pigmented, but not the forehead.

Hitherto we have referred more particularly to the preventive nutritional and medicinal treatment of defects and deformities; it has, we opine, a certain future.

ANTENATAL TREATMENT.

Perhaps it will now be profitable to consider the subject of disease from the same standpoint.

To start with, we may not do amiss to realize the fact that we get, so to speak, a capital leverage for our therapeutical work, in as much as we have a number of months in which to accomplish it. We know from daily experience that numerous diseases can be cured by a course of treatment spread over a considerable period of time, but which cannot be modified to any great extent with any one given remedy. The various remedies follow one another like steps in a staircase, and they are all needful to reach the top.

Then we have the most favorable physical conditions. Our foetal patients are not exposed to change of temperature, but have a constant temperature in the best possible medium, and they are pretty sure to take their physic regularly.

Ever since my attention was arrested, as before stated, by the observations of hare-lip, I have sought opportunities of testing the truth of this theory–that the body fruit, while still within the womb, can be nutritionally and medicinally modified at will. Further cases of deformity have not presented themselves, but in general practice I have had some opportunities of observing the beneficial effects of the medicinal treatment of pregnant women for the prevention of various to-be-expected morbid states.

Thus, a lady patient of mine has a good many moles and warts on her persons, and her husband a great number of warts, some very unsightly, on his. Considering the frequent observations that warts will, at a more advanced period of life, take on increased action, hypertrophy, and become epitheliomatous, their presence in an individual is not only aesthetically undesirable, but may become the source of positive danger to life; at any rate, they are ugly things at the best. Moreover, both of them are rheumatic and constitutionally strumous. This lady has passed through four pregnancies under my observation and professional care, and during each one I subjected her to a course of treatment with the most happy results. The four children were born with unblemished skins– wartless, moleless, and spotlessly pure.

It may be objected that the treatment had nothing to do with this purity of skin, as the interesting babes might have been equally unblemished, without any treatment at all. Of course, I cannot prove the contrary, still–

“Like genders like, potatoes breed,

Uncostly cabbage springs from cabbage seed.”

My belief is, and it is based on observation, that those four children would in all probability have all been born with unsightly warts on various parts of their persons had the mother not been treated to prevent it.

The course of treatment followed was in this wise a peu pres. Sulphur, generally in the sixth, twelfth, or thirtieth dilution (by preference the last-named), was given as the most certain anti-psoric. This was granted time to act, and then followed Thuja occidentalis as the anti-sycotic par excellence. Lest any specific taint lay in its history, Mercurius was given. The lady’s teeth are very carious, and hence Acidum fluoricum was given for a while; the children have thus far sound toothie-peggies, and teethed normally and without any mediaevally superstitions gum-lancing.

Apropos of gum-lancing, if those who still adhere to this barbarous practice would just work up the indications of Aconite, Belladonna, Ferrum phos., Kreasote, Calcarea carb., Calcarea fluorica, Silicea, Phosphorus, and the like, they would soon have, as I have, a very rusty lancet, and a very grateful heart, that they no longer need to pain the poor bairns and constitute themselves dreaded objects. Moreover, they would soon satisfy themselves, after a little careful observation, that the gums are not the offending parts, but the unfinished, abnormally constituted teeth, and a morbid something lying behind and beyond in the constitutional crasis. Sapientibus sat.

A lady, mother of several (five ) children, was under my treatment for a chronic internal skin affection; her husband had formerly been successfully treated by me, for psoriasis of lower extremities, with Arsenicum.

The last baby I had treated for eczema while still at the breast, and when it was vaccinated the arm became very seriously inflamed, and the object of anxious care and medicinal treatment. All the five children had had, was informed, something wrong with the skin, and every scratch with them festered.

The sixth pregnancy occurred, and I treated the lady during the greater portion of it. The principal remedies used were Psorinum 30, Sulphur 30, Calcarea sulph. 6, and Juglans cinerea 1.

The child came in due course; everything was normal, and the little manikin was the finest of the lot, and remained for two years with a pure skin, and the vaccination caused no inconvenience. All the other children had had cutaneous affections before they were a year old, and some of them proved altogether intractable.

The child passed from my observations then, but I have heard that it now has “something on its arm,” but what I do not know. Supposing it to be a cutaneous affection, the result of the preventive treatment would be that it remained free for the first two years of its life; and moreover; it is by far the finest and handsomest of the six children.

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