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. 6x 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 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.
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, 1870, a distinguished gentleman called on me and invited me to visit his sick child, who, he said, had been under the care of three physicians, one of them being Professor F., of Moscow University, whose speciality was children’s diseases.
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 leptomeningitis. 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 doing 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 still a young woman and nursing her youngest child, through sorrow and trouble had nearly lost her mind.
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 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 extend; chalk-white stool (similar to what might occur from an exclusive mild 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 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 listed over one hour the cheeks began to redden, the temperature increased to 39. 3C, 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 11.30 a.m., when amelioration began, so that by 1p.m. the condition was nearly normal. Nux 3x and Bellad. 3x, two drops every two hours in alternation were given; milk and water were forbidden and only wine and water with a little sugar were allowed as drink. The body to be rubbed with 90 degree spirits.
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 not 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, 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 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-eight day after having the last paroxysm, and with a strict diet, in three weeks she was able to leave her bed and walk about.
In 1876 I saw her for the last time. She was then in good health and I have not heard from her 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 (<) 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.
