For several years I have been in the habit of using this drug in true Rademacherian fashion as an organ remedy. The perusal of Rademacher`s Magnum Opus is one of the greatest literary treats that ever fell to my lot; based on Hohenheimian bizarries, avowedly and obviously merely an attempt at reducing his genial erratic pretended mysticism to the concrete form of a practice of medicine, by depolarizing it, if I may so speak, it is nevertheless the most genial and most original production it is possible to find in medical literature. It is the most bare-boned lawless empiricism that one can conceive, and yet there are two leading ideas running through the entire work, and these are the genius epidemicus morborum and organopathy; and considered from the pharmacological side, the other two ideas of universal (general) and particular medicines. For Paracelsus there were only three universal remedies, and so also for Rademacher and for their followers. Hahnemann has but three fundamental morbid states-psora, syphilis, and sycosis. Von Grauvogl has but three constitutions of the body-they might have all been working out the father-landish proverb Aller guten Dinge sind drei!
The genius epidemicus morborum is beyond question a fact in nature, but it is dreadfully eel-like, hard to get a grip of. The same may be said of Hahnemann`s tripartite pathology and of Grauvogl`s three constitutional states.
Rademacher`s organopathy (that an otherwise able modern writer appropriates with child-like naivete) is no more and no less than the homoeopathic specificity of seat, with just a dash of a mystic psychic something in the several organs; if we set aside this little particular soul for each organ, it is only local affinity, or elective affinity. And it is quite true in nature, and the mind that cannot, or will not recognize it, is wanting in catholicity of perception; and in practice will often go a mile when three paces would have reached the goal. Whatever else Cantharis may be, it is first and foremost a kidney medicine; whatever else Digitalis may be, it is primarily a heart medicine; and let Belladonna be what, it may, it is before all things an artery medicine, and just in this sense Ceanothus Americanus is a spleen medicine.
The spleen constitutes a dark corner in the human economy, whether considered physiologically or therapeutically.*”Qu’est-ce que la rate? Telle est la question, assez etrange, posee depuis trois mille ans dans la science, et dont, apres trois mille ans, la science a jusqu’a ce jusqu’a ce jour vainement attendu la solution.” -Bourgery. *I have heard it professorially very ably argued that the spleen is the principal manufactory of our blood corpuscles. I have heard that theory equally and professorially refuted, and in its stead the thesis set up that the spleen is, as it were, the ultinum refugium of the old and effete blood corpuscles, wherein they are broken up and their debris sent off again in the circulating medium. A third argued that all this was veritable nonsense, as the spleen had nothing whatever to do with either making leucocytes or breaking up their reddened descendants, that in fact the spleen had no other function than to act as a reservoir for the blood -being, indeed, a king of living sac in the side, to swell or shrink according as the circulation required more or less of the circulating fluid.
I fondle this latter theory myself, and like to call it mine; whose it really is I do not know. Perhaps some of my readers will be able to say what they think the spleen is good for beyond serving as the anatomical something that supposedly sends our dear fellow-countrymen in shoals off London Bridge into the Shames on a rainy or foggy day-I mean, of course, le spleen! This great bugbear of our Gallic and Germanic brethren-as applied to ourselves bien entendu! for they consider it essentially principally a morbus Anglicus, just as we like to think it is principally those naughty French who commit suicide-is really only another name for being “hipped, ” or suffering from an attack of hypochondriasis, and there cannot be any sound reason for refusing it a habitat under the left ribs, since so many have welcomed it under the right ones.
My first and only literary acquaintance with Ceonathus Americanus is the very short empirical; account of it in Hale`s New Remedies, which I read rome five or six years ago. Previously I had frequently felt a difficulty in treating a pain in the left side, having its seat, apparently, in the spleen. Myrtus communis has a pain in the left side, but that is high up under the clavicle; the pain that is a little lower is the property of Sumbul; still lower of Acidum fluoricum; a little further to the left of Acidum oxalicum; more to the right of Aurum; right under the left breast of Cimicifuga rac.
These remedies promptly do their work when these left sided pains are a part of the disease-picture, but they will not touch the pain that is deep in behind the ribs of the left side: more superficially Bryonia has it; a little deeper than Bryonia, Pulsatilla nuttal. will touch it; and so will Juglans regia, which poor Clothar Muller proved as a student. But the real splenic stitch requires China, Chelidonium, Berberis, Chininum sulphuricum or conium, or Ceanothus Americanus.
Some years since I treated a lady for “violent vomiting, pain all up the left side, cough with expectoration, profuse perspiration, and fever.” She was not a native of the place, but came only for a short visit, and took lodgings in a small house facing a meadow on the banks of the river; the locality was at one time a part of the port, but was many years ago reclaimed. At my first visit she told me she often got inflammations on the chest with cough, and finding considerable fever, cough, pain in left side, and dulness on percussion of the same side, I quickly ticketed it pleuro- pneumonia sinistra, and gave Acidum oxalicum, which seemed to cover all the symptom, and to correspond also to the supposed pathological state within. Oxalic acid some what relieved the vomiting, but nothing more, and I then gave various remedies, such as Aconite, Bryonia, Phosphorus, Ipecac., and thus elasped about three weeks, but patient remained as ill as ever. Then I went into the case with very great care, and examined my patient very thoroughly, and see, there was inflammation of the spleen. I gave her Ceanothus Americanus in a low dilution, and all the symptoms, subjective and objective, disappeared right off, and my previously ill-treated patient was sitting up in a week, and quite well in a few more days. I had never before met with splenitis in the acute form, and indeed, it is a very disease in this country.
Cases of chronic pains in the spleen occurred subsequently in my practice, and they rapidly yielded to Ceanothus, one of which I well remember; it is this:-
Chronic Splenitis.-A young lady of about 26 consulted me for a chronic swelling in the left side under the ribs, with considerable cutting pain in it. She stated that it was worse in cold damp weather, and she always felt chilly; the chilliness was so severe and long lasting that she had spent the greater part of her time during the previous winter sitting at the fireside, and now she was looking forward to the winter with perfect dread. In the summer she had felt nearly well, but the lump and the chilliness and pain nevertheless persisted, but it being warm, she did not heed it much it being quite bearable.
Ceanothus Americanus quite cured her of all her symptoms, and subsequent observation proved its permanency. Often during the following winter she called my attention to the fact that she was not chilly and felt well.
Another case which I treated at a later date was that of a young man somewhat similarly suffering.
Chronic Splenitis.-The young man had been sent to my dispensary, and was occupied in the post office in some light but ill-paid employment. His whole trouble consisted in severe pain in the left side in the region of the spleen, and he had long vainly sought relief of many, probably at dispensaries. He, therefore, put in an early appearance at my new dispensary to try the new doctor, probably on the well known principle of the new broom. He had become quite low-spirited and began to fear he would become totally unfit for work, and naturally that was a very serious matter for a young married man. He told me he had formerly helped his wife in her household matters, doing the heavy rough work, but the pain in his side had now become so bad that he could not carry a bucket of water into the house or even sweep up their little yard, as handling the broom pained him so dreadfully. I was pressed for time, and prescribed Ceanothus Americanus in pilules of a low dilution, and promised to go into his case that day week, meaning to percuss the part and ascertain whether the spleen was enlarged. He returned that day week almost well, and following week was quite well. At my request he again reported him-self time afterwards, and he still continued well.
I resolved to begin my next case with a physical examinations. My next case was this-
Chronic Hypertrophy of the spleen.-A middle aged lady consulted me, shortly after the above case, for a severe pain in the left side and a large swelling in the same position. Remembering the last case, I said I must examine the side. She objected, so I declined to treat her; then she said she would think about it consult with her husband on the subject. In a fortnight or so she returned (driven by the severe pain in the side), and I examined the side and found an enormous spleen occupying the entire left hypochondrium and reaching inferiorly to about an inch above the crest of the ilium; it bulged towards the median line and ran off to an angle laterally. It was of long standing.
Gave Ceanothus Americanus in a low dilution.
The lady being very intelligent I begged she would allow me to examine the side again after I had finished the treatment. She promised to comply.
Fourteen days after this she came full of gratitude, and reported that the swelling was smaller and the pain considerably less.
To continue the medicine, she never consulted me again, but as she was a near neighbour of mine I often saw her, and somewhat six months afterwards she called to pay my fee, and then informed me that she has soon got rid of the pain entirely and the swelling was much smaller, so she had discontinued the medicine altogether, and did not deem it needful to trouble me again.
This is the usual thing. People will not be at the trouble of seeing the doctor as soon as they are better, they seem not to understand any interest one feels in the case. We can only make periodical reliable examinations of patients in a hospital; in private practice it is extremely difficult, as all practitioners know to their chagrin. Still, faute de mieux, we must put up with these fragments. This patient has had no children, and had a very fresh complexion.
My next case is also one of Chronic Hypertrophy of the Spleen, though only about half the size of the one just narrated. Subject: a poor woman of about 30 or 32 years of age, whom I was requested to see by a very kind-hearted benevolent lay minister. She is the mother of several children, very poor, ill-fed, and over-worked, but with all a good, respectable woman, very clean. She had a considerable and very painful swelling in the left side under the ribs, that had been there for some time, latterly she could not get up on account of the severe pain. I carefully examined the tumor and satisfied myself that it was a very much swelled spleen, and the pain seemed to me to be due to its pressing against the ribs. I marked its size on the skin with ink, made her engage not to wash off the ink mark, and promised her I would call in a week, having first prescribed Ceanothus as in the other cases. But the fates were against my laudable plan, for I received a message, the lady before my next visit was due, to the effect that Mrs.-felt herself so much better that she was up at her housework, and begged me not to call again, as she thought it unnecessary.
Since then I have at times had cases of deep-seated pain in the left side to treat, and have mostly found it yield to Ceanothus, though not always. In one case in which it failed the pain was cured with Berberis vulgaris.
In one case of jaundice, characterized by very severe pain in the left side, I gave Ceanothus, with very prompt relief of the pain only; Myrica cerifera that finished the icterus. Before giving the Ceanothus I had given Chelidonium majus.
In one case of severe metrorrhagia characterized by pain in the left hypochondrium, Ceanothus gave instant relief to the pain, and checked the haemorrhage. It failed me in a subsequent similar attack in the same person, when Conium was effective.
Chronic Splenitis, Chills, and Leucorrhoea.-Some four years since, perhaps a little more, I treated a lady of about 55. She complained of rigors ar frequent intervals, and pain in the left side, both of long standing.
The leucorrhoea had lasted some twenty years, and was profuse, thick, and yellow. She had been for years under the best Allopathic physicians of her native city, and finally given up as beyond the reach of medical art, evidently on Moliere`s principle that “Nul n’ aura del’esprit que nous et nos amis.” Nevertheless, the patient bethought her of Homoeopathy, and came under my care. Her last physician had finally suspected cerebro-spinal mischief, and hinted at incipient paralysis.
The pain in the side was the most prominent and distressing symptom, and for this I prescribed Ceanothus. In a month the pain was entirely cured, and also the leucorrhoea, while the cold feeling was very much diminished, but not quite cured. I have also never succeeded in quite curing it with any subsequent treatment. I watched the case for nearly four years, and am thus enabled to state that the pain in the side and the leucorrhoea never returned, and the chilliness never again became very bad, but still she had it a little when I saw her last.
CASE OF ENLARGED SPLEEN MISTAKEN FOR HEART DISEASE.
A few years ago I was attending some of the members of a family of position in London, and at my various visits I occasionally heard of an invalid daughter of the family suffering from a hopelessly incurable disease of the heart, for which she was said to be under a West-End physician, who was thought to devote himself especially to diseases of the heart. The heart was said to be enormously enlarged, and the patient had to give up first dancing and then hurrying, and finally she was only allowed to walk very slowly and carefully, lest the hugely enlarged heart should rupture. Several physicians had examined the case, and all were agreed as to its cardiac nature. I had never seen the young lady, and took no particular interest in the frequent narrations of her heart troubles; they are common enough. Time went by, and the mother used to speak of her “poor invalid daughter” with increasing despondency, finishing up one day with remark that the unfortunate girl was no longer allowed even to walk, as doctor considered even that now fraught with danger. “Is it not sad?” said she. “Would you like to see her?” I declined, saying, I never cared about seeing other physicians’ patients.
More time lapsed, and finally I was requested to take the case in hand. I demurred at first, because such hopeless cases are as unsatisfactory as they are painful.
At last I consented to take over the case, and I appointed a time to call and examine the patient.
During all my professional life, I have rarely been more taken aback than I was after I had made my examination of the patient, for I found the heart not only enlarged, but of the two rather abnormally small, although apparently the cardiac dulness extended a foot down the left side. But this dulness on percussion was due to an enlarged spleen which pushed up the diaphragm and left lung by its bulk, till the heart and the spleen gave one continuous dull percussion note. Patient had many genuine symptoms of real heart diseases-dyspnoea, palpitation, inability to lie on the left side, faintness-but these were due to the mechanical hindrance to the heart`s action produced by the spleen bulking upward so much.
That young lady I meet three weeks ago looking blooming, and as agile as possible, and she has done her share of dancing, tennis, etc., for some years. Ceanothus Americanus cured the enlargement of the spleen for the most part, though it swelled again two or three times at some months’ intervals, and Ferrum phosph., Conium, Thuja, Berberis, and other splenics, came into play before patient was really well. Looking at the case now with the advantage of wider experience and more matured views of biopathology, and with the patient fully six years under my observations, I regard the affection as a primary disease of the leucocytes due to vaccinial infection, the spleen being disturbed secondarily, and then the heart mechanically. I am confirmed in this view by the fact that the spleen would not leave off swelling up at certain times till I had cured the vaccinosis. That prince of splenics, Ceanothus Americanus, readily cured the splenic engorgment, but did not touch the blood disease which caused it. This is the inherent defect of organopathy, that it is not sufficiently radical in its inceptive action, but the like remark applies to every other pathy more or less, because the primordial cause is more or less elusive, and generally quite beyond positive science, which only admits of what it knows, and will not seek to encompass the unknown by the processes of thinking and reasoning. Because in former times philosophy made science impossible, the votaries of science now round upon philosophy, and sneer it out of view. To trace back proximate effects to remote causes is now ridiculed in medicine because mere science is productive of gross mindedness, incapable of following the fine threads of the higher perception.
It was also about the same time that I was at the house of a patient in London, the wife of a general officer and the conversation fell upon the general`s heart affection, and also upon that of their charwoman. I learned that the lady of the house took a certain interest in her charwoman because she had seen better days and had an invalid husband depending on her labour more or less. This charwoman was, it was said, suffering from an incurable disease of the heart, causing her terrible distress; on rising in the morning she would have to fight for her breath, so that it would take her often three-quarters of an hour to get dressed, having to pause and rest from the dyspnoea and its effects, nevertheless she persisted in thus getting up and dressing, and did as much charging as she could get. Her pride would not allow her to beg of her friends. Such was the story, and I really felt curious to see the charwoman, and promised to do what I could, though from the account given to me by the general`s wife, I certainly thought it quite a hopeless case.
Calling a few days later, I saw the lady and the charwoman, and having duly examined the latter, I promised to cure her! She was to come to my city rooms, and report herself every fortnight. On returning from the bedroom to the drawing room, the general wife accused me of cruelty in thus raising the poor old woman`s hope “when,” exclaimed she, “you must know it is impossible.” I tried to explain that it was a case of enlarged spleen, and not the heart disease at all, that the charwoman was suffering from, and that the palpitations and fightings for breath were the mechanical sequels of the splenic engorgment, but my patient evidently did not believe it, for she wound up by saying, “As you will treat her for nothing, i hope you may succeed, and it is very kind of you, but you must know that the poor woman has been under various doctors, and all have declared it incurable heart disease, and I merely wanted you to tell me of something to relieve and ease the poor old thing.”
This was towards the middle of October. A careful physical examination showed that the heart-sounds were normal, but there was much beating visible in the neck, and the heart`s action was labored. In the left hypochondrium there was a mass corresponding to the position of the spleen, and a dull percussion note was elicited not only in the left hypochondrium, but also in the right, and all across the epigastrium, or pit of the stomach, from side to side. The following notes were put down at the time: “Heart- sounds, normal; apex beat, exaggerated; splenetic dulness extending up to the left mamma; the whole region very tender, so much so that she cannot bear her clothes or any other pressure.” The prescription was: Ceanothus Americanus lx 3ij, five drops in water three times a day.