It is difficult to find good spleen remedies, because the spleen, as compared with the liver, is seldom painfully affected in its substance. When it pains, the pain is most commonly at the margin of the epigastric and left hypochondriac region rather than in the hypochondrium itself. But, alas! just at this very spot liver affections also often express themselves, so this symptom is uncertain. The comfortable lying on the left side, and the impossibility of lying without distress on the right side, certainly speaks for a spleen affection provided always that the left lung be not affected. So it is very well to pay attention to this symptom, it is an uncertain one. People whose spleen is much affected like to lie on their backs, just as do those who have the right lobe of the liver much enlarged, and neither can lie comfortably on their sides. When we further bear in mind that the spleen (so far as we know at present) is neither an excretory nor a secretory organ, it follows that we cannot have any symptoms indicating a disturbance of such-like functions. When we further consider that the gall ducts are sometimes sympathetically affected in spleen complaints, with the urine discolored as in gall affections-that, in fact, the menstrua digestion is in general are qualitatively altered; and that to fill the cup of difficulties to overfilling, abdominal plethora will simulate painful spleen disease; it is easy to see that the findings of good spleen medicines is, indeed, a very difficult affair.
The states and symptoms that, during my medical career, I have known to arise more or less frequently from spleen affections are the following:
Pain in the stomach (often).
Cough, and that oft, violent, and suffocative.
Bellyache (at times).
Chronic diarrhoea, and rather more frequently.
Disturbed renal functions and their consequent dropsy.
And with regard to such dropsies, in so far as they are not due to organismic affections, I ascribe, according to a rough calculation, about one-third to the spleen.
In women the spleen affects the womb and the vagina, causing emansion, or excess of the flow, and leucorrhoea. (This I (Burnett) have myself observed very frequently, and also a very distinct sympathy between the male urethra and the spleen, which Rademacher does not appear to have noticed, since which Rademacher does not appear to have noticed, since probably peccant urethrorrhoeae were not very common in a place like Goch.)
Not a few acute fevers of a secondary nature (consensueller Art-synorganismie) and agues are the mere concomitants of spleen disease. When abdominal affections are prevalent, we at times meet with splenic fever. But in this one year differs from another. At one time, when liver affections were prevailing. I have not to treat a single case of spleen fever in a whole year, and at other times, liver affections still prevailing, I have had here and there an intercurrent case or two of spleen fever.
Brain affections, such as mania and melancholia, eye disease such as diplopia, amblyopia, chronic inflammation, I have seen arise from the liver, but thus far not from the spleen. If I had ever witnessed an epidemic of spleen affections, I should know more about the organ. As it is, what I have to say about spleen medicines can only be imperfect.
Rademacher speaks of the difficulty of really diagnosing a primary spleen disorder, and then says:
Continuous asthma, worse at night, is not a common complaint. It may be, like the cough, of a synorganic (consensueller) nature, and depending upon a spleen affection. Not long since I witnessed an instructive case of the kind. A man who, in his youth, had had a moist eruption all over his body, which eruption was fruitlessly treated with medicines, but went away of itself in adult life, but left behind an ugly fishskin- like epidermis, began to complaint of tension in the left hypochondrium, becoming at times a little painful. He did not, however, consult me for this, but for shortness of breath. I soon ascertained that he had had the tension in the hypochondrium much longer than the asthma, and so thought he was suffering from a disease of the spleen, and which I thought the more likely, as he had never had the least the matter with his lungs. Well, I did not give this man Carbo, but another remedy, and the complaint got visibly better. When it had reached a certain stage of improvement, he was hard hit by a then prevailing liver fever which in his case implicated the chest. This chest affection, however, did not consist in the previous asthmatic attacks, but in pain in the side, with cough and bloody expectoration. He got well, but hardly was he able to be up all day when the old asthma came back worse than ever. Thinking the liver complaint might not be quite cured, I gave him a good hepatic, but the asthma remained. Here I gave him the spleen remedy-the splenic-which had done him so much good before the acute affection came on. The man asked for it himself, but it did no good at all. Asthma and cough remained, and instead of picking up after his acute disease with good nights’ rest, the asthma drove him every night out of bed. I now gave him Carbo, which soon altered the face of things. Cough and asthma lessened; the latter soon disappeared altogether, so that the man was able to make the hour and a half walk home to his friends, who had given him up.
But not every case of asthma, due to the spleen, will yield to Carbo. These stomach pains, that, as they pass off, lose themselves in the left hypochondrium, and which I put down to the spleen, I have at times cured with Carbo; more frequently, however, with other spleen remedies.
Kidney affections, with dropsy due to primary spleen disease, I have never tried to cure with Carbo, because I thus far have managed to cure them with other remedies, and I do not hold it to be right to try experiments from mere curiosity.
In my youth I used Scilla, like so many other physicians, as a pectoral and diuretic. But findings it thus used so little helpful, I gave it up in contempt. During the last twenty years, in which I have taken more interest in the affections of single organs, I came to recognize the necessity of findings out good and reliable remedies proper to the various organs, and as I had indeed such a very poor stock of spleen medicines, I read one day in an old Galenic author (I really don’t remember now in which) that Scilla was a very good splenic. Dioscorides also reckons it to the spleen medicines, but he has put down so many drugs remedies that one`s whole life would not suffice to try half of them. All things considered, I thought the old Galenic`s idea not a bad one, and from that time on I have used Scilla as a spleen remedy, and I have never given it up since.
Although I may be in some doubt as to whether Carbo veg. really acts healingly upon a diseased spleen, I am, on the contrary, very sure about Scilla. I have found it quickly and surely helpful in such painful spleen diseases-affections painful and beyond any doubt in and of the spleen.
In those dull pains on the border of the left hypochondriac and epigastric regions, there being no signs of any liver affection (a rather uncertain and negative), I have used Scilla as a remedy with advantage.
I have also used Scilla with very striking results in those so-called stomach pains that are made so much better by lying on the left-side, and which in all probability depend upon a primary affection of the spleen.
Finally, I have used it with good results in one case of continuous asthma from a spleen affections, with nocturnal exacerbation, and in which Carbo has been used in vain, but in this case the spleen engorgment was of such long standing that I hardly believe in its being radically cured.
As to the dropsy that depends upon a diseased I no doubt gave it in former years in such also, for I dare say I gave Squilla to nearly all my dropsical patients; and that may account for my having found it so useful in dropsy, but I am not so very sure. But since I have had the habit of trying to find out in all diseases the primarily affected organ (provided the to be-cured diseases be not a primary one of the whole economy) I have not used it, for the very sufficient reason that I have not needed it, but of which more anon.
The preparation I prefer is the tincture 15 to 30 drops five times a day. In case where it caused diarrhoea in these does, I have had to come down to 5 drops three times a day.
AQUA VEL TINCT. GLADIUM QUERCUS
I became acquainted with this remedy in a wonderful way. Many years ago (I do not remember the exact time) a working carpenter, who had previously lived in Credfeld, came to seek my advice for his bellyache; which was of long standing. According to his own statement, he had long been under Sanitary Councillor Schneider in Credfeld, who was not able to help him, and sent him to professor Gunther in Duisberg. Ten journeys thither were likewise in vain.