CASE XIII. Sycosis. Thuja and Nat. sul.
Herr von Z—, 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 was 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. 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 sized 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 was 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 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 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 was 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.
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 a.m., reaching its height at 12 midnight, and then declining with morning, so that between 7 and 8 a.m. he has the greatest relief. The appetite was poor, the stool torpid, urine normal, the old gonorrhoea still existed in a mild form, with slight discharge and no pain. He slept very little either in the night or during the morning remission. The head pains were greatly (<) by noise and light. If he was spoken to he answered in a monosyllabic, depressed, weeping manner, hesitating long on his answer, and not always comprehending the question, and when alone he lay as if in a stupor. He was (<)in damp weather. The only thing which gave him comfort was a temperature of 38 to 40 R. (118-120F). This he sought daily in the special room of the Russian baths, nor could he admit any moisture into this room, and the heat gave no relief to the headache.
It should be noted that the above facts were not obtained at my first visit, but later on wen 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 200 in four ounces of water, a teaspoonful morning and evening; whilst during the day he received Nat. sulph. 2x, two drops three or four times a day.
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, old-school physician in Taroslaw, presented, of 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 cold give no other cause than that he had for a long time, in the spot now occupied by the swelling, a dull, so-called rheumatic pain and that the swelling had grown very slowly to its present size. Of his previous history we learned that while he had never enjoyed good health, he was liable to “catching cold,” and had noticed that all his ailments were accompanied by chilliness, which was also true at the present time. All his lesser indispositions presented an irregular intermittent character.
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 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.
