5. Cholecystitis. Therapeutic plan.
1. Biliary drainage. Cholagogs and choleretics.
Lower dilutions of Solidago, Carduus Marianus Berberis Podophyllum, Taraxacum, Hydrastis.
Decoctions of Taraxacum, Artichaks (leaves), Rosemary (leaves) wild Chicori (leaves), Boldo, Podophyllum.
Ponderable doses of Magnesia sulphurica, Magnesia muriatica.
Haarlem oil (small doses at long intervals)
Olive oil, biliary salts
Mineral waters (with care)
1. Homoeopathic remedies properly called.
(a) External Liver. Compress imbibed with mother tinctures of Chelidonium, Berberis, Carduus marianus, Bryonia, Chionanthus, Colocynthis, Chamomilla, Dioscoria, China, Myrica.
(b) Internal Liver. Pain Colocynthis Bryonia Dioscorea Magnesia Phosphorica.
Infection : Baptisia, Gelsemium, Eupatorium Perf, China, Arsenicum album, Echinacea.
The homoeopathic remedies indicated in the fever of cholecystitis are often the same as that of intermittent fevers because of the similarity of the temperature curve in both the cases, besides analogous clinical pictures.
Hepato-biliary insufficiency (Use the ground remedies) Ricinus communis, Cocculus, Nux vomica, Ipecac.
The Mercuries. Vipera, Anacardium, China, Chelidonium, Myrica, Chionanthus, Ptelia, Kali carbonicum, Juglans cinerea.
Ground remedies (or remedies of morbid temperament).
Phosphorus, very often
Arsenicum Album, Lachesis Lycopodium (with great care)
Natrum Sulphuricum, very often.
Rarely Graphites, Ignatia, Nux Vomica, Natrum Muriaticum, Sepia, Sulphur, Psorinum, Aurum Metallicum, Silicea Calcarea Carbonica.
3. Isopathic Remedies and Nosodes.
Cholesterinum (200, 1000, 10,000)
Lecithin, Lutein (high dilutions)
Individual blood isopathy, stools or urines.
4. Organotherapy. Three types of prescriptions :
—Substitutive organotherapy. Ponderable doses.
—Excitant organotherapy. Lower triturations or medium dilutions.
—Regulatory organotherapy. High dilutions (100-10,000)
Extracts of liver, pancreas, ovaries, spleen, kidney, biliary calculus.
Two failures, about 8 years ago after habitual homoeopathic treatment led me to think about the question of drainage. I was not content to use different other remedies which are not classic. I wanted at first to obtain a good drainage of the bile in my patients. Homoeopathic organotherapy, particularly Fel tauri and Bilis in the 3rd and 6th dilutions appeared to me to act though in an inconstant manner. Among the organotherapic remedies the specialised products called proxitasis seemed to me to have interesting action. But it was not sufficient. Haarlem oil seemed to me more satisfactory. This is a secret product of Holland of the 16th century, always used, contain different plants mixed with the essence of Terebinthina and Sulphur. I still use this compound. A good remedy of drainage is also Magnesia sulphurica;but it should be used in Allopathic doses as for example a tea spoonful every week. In this way colics in case of simple cholecystitis may be prevented.
In homoeopathy we know already as remedies of drainage Solidago virga and Carduus marianus. But these remedies are very little effective in confirmed cholecystitis. The theory of drainage formulated by Dr. A. Nebel of Lausanne which leads specially to the treatment of cases of bile and cholesterin retention, has some deductive value in therapeutics. Let us recall the action of Carduus on the left lobe of the liver, its constipation of frothy stools, difficult and hard, its tendency to jaundice, with dark pigmentation on the skin; its evolution towards cholecystitis and pigmentary cirrhosis or ascites, its pre-cancer state. We should knew that the pain of Solidago is localised on the kidneys in the J. L. Petit’s triangle or in the costo-vertebral angle, its rare urines which are thick, with thick and red-brick deposits; its saburral tongue and the bitter taste in the mouth.
The decoction of Boldo may be used as a drainage remedy or one may use the plant in low dilutions but its actions is inconstant and very slight. Boldo seems to act always in the case of bitter taste in the mouth.
Two homoeopathic remedies which are very important should be mentioned here. Hydrastis and Taraxacum. these remedies are to be given in 3 or 6.
Hydrastis. Acts very slowly. It is a remedy of mucous membranes, specially of those that covers the exterior conduits, with multiple folds. There is on the membranes in question, a thick, viscous and yellowish discharge. It is the ‘thick bile’ of ancient authors. Its habitual symptoms are bitter taste in the mouth, atonic dyspepsia with slow digestion and great weakness, possible jaundice. Pre-cancer stage.
Taraxacum. The Dandelion, is a very excellent remedy, very often underestimated, of torpid liver with stubborn constipation, bitter taste in the mouth, big and indurated liver, abdominal meteorism, mapped tongue white with red patches like islands. Salivation of hepatic region. Night sweats. Fever with chill after meals. Pre-cancer stage.
Podophyllum. Elective action on duodenum. May be used as a cholagog, if it is indicated by its vomitings of bile, clear yellowish and profuse diarrhoea early in the morning, accompanied by prolapsus of the anus. But in homoeopathic dilutions Podophyllum may often cause constipation. Therefore it is not considered as on ideal drainage remedy in the case of the stoppage of bile excretion.
Finally Berberis should not be neglected. It is a remedy of drainage type with its weakness, its hepatic insufficiency, its pains in the region of the left kidney, its thick urine, difficult and high colour.
Really speaking all these remedies are not sufficient. It is necessary to act in a different way and on upper level.
–Act on the general condition and on the altered sympathetic system i.e. to say on the principal symptoms of the affection in question, pain, the defense symptoms, the fever, the infection.
–Finally act on the hepato-bilio-pancreatic insufficiency, the principal responsible factors of the cholecystitis.
2. Remedies Indicated by Pain and Fever.
I will not dwell on the remedies specially on Colocynthis, Dioscoria Villosa, Chelidonium, and Bryonia. They are well known.
Colocynthis. Colic of the liver after anger. Very violent spasmodic and crampoid pains, OBLIGING THE PATIENT TO BEND FORWARD WHICH AMELIORATES THE PAINS.
Dioscorea Villosa. Is very often indicated in hepatic colic which FORCES THE PATIENT TO STRETCH AND BEND BACKWARDS FOR AMELIORATION. Irradiation of the pain from gall bladder to the chest, back and arms.
Chelidonium. CONSTANT PAIN BELOW ONE OR TWO CENTIMETRES OF THE LOWER ANGLES OF THE SHOULDER BLADE. Irradiation to the shoulders, specially to the right shoulder. Biliary complications of pregnancy. Possible jaundice. Big liver, painful. Discoloured stools with constipation.
Bryonia. PAIN AMELIORATED BY COMPLETE REST. Aggr. by movement which forces the patient to remain quiet. The liver is big and painful, Constipation of hard, voluminous, dry stools as if burnt.
Different remedies have been used in cholecystitis. Such as: Baptisia. In the case of Eberth’s bacillus and of para- typhoid, very grave with septicemia, delirium; dry yellowish tongue “Parrot tongue”, hebetude, foetidity of breath and of the excretions. BED SEEMS VERY HARD.
Eupatorium Perfoliatum. INTENSE PAIN OF THE BONES OF THE EXTREMITIES AS IF THEY ARE BROKEN. High fever. Bitter taste in the mouth. Painful liver. Great thirst. Hiccough. MARKED PERIODICITY.
Gelsemium. Great shivering, specially aggravated at 10 in the morning. FEVER WITHOUT THIRST. Adynamia with nausea. Intermittent fever.
I must admit that I have very little experience about the classic remedies of fever as regards biliary infection except Gelsemium of which I had an important case which proved its value. On the contrary the remedies indicated by pain Bryonia, Colocynth, Chelidonium, Dioscorea are very important to consider, because, as I have noted, they may have a rapid calming effect on an infected and painful gall-bladder.
But above all, in these cases, one should know how to use these remedies externally, in compress on the liver. This method is neglected by the homoeopaths and they are wrong. Here is how one proceeds. The M.T. should be used because even the lower dilutions do not act, or act less. The patient should apply on the region of the liver a big compress of double flanel, humid and soaked with water, then pressed. The water according to the case and the modalities of the remedy may be used, cold, hot or tepid. On this compress sprinkle some drops of (5 to 10) of M.T. of two or three medicines. Naturally a mixing of a number of tinctures should be avoided, because the action will be less and it will not be possible to know the tincture of which the action is optimum. In our practice the mother tinctures that we apply are those of Berberis, Chelidonium Bryonia, Chionanthus, Myrica and China, and sometimes Dioscorea, Colocynthis, Eupatorium. The sedative action is rapid; the pain ameliorates and above all the contraction and the perivesicular plastron becomes soft and finally disappears.