Cases



CASE OF GENERAL VARICOSIC VARICOCELE, AND VARICOSE VEINS.

A gentleman about thirty years of age, came under my observation on october 17, suffering from chronic prostatitis, varicocele, and varicose ulcers of the legs. At a glance one could see that he was a venous subject; as he was swarthy, pensive and melancholy, and had long slender limbs. Almost every region of his venous circulation showed signs of dilatation, having an enormous left-sided varicocele, and very pronounced baggy varices of the legs. His internal saphenous veins were like big robes. Around his left ankle were varicose ulcers, and the whole neighbourhood around was very dark, almost black in places. He stated that this left ankle had been in this state nearly all his life. General health fairly good except some lack of virility, but bandaging his legs was, of course, burdensome and the varicocele was very inconvenient, more especially in view of approaching marriage.

Rx Ferrum Phosphoricum, 6 trituration 3iv. To take four gains in water three times a day.

Nov. 12 The spermatic veins are not any smaller as far as he can perceive; the veins in his lower extremities are smaller; and the dark places under the left ankle are turning to a proper flesh colour.

Repeat the same flesh Remedy.

Dec. 8. The varicocele is much smaller – “At one time its existence was very inconvenient; now I hardly notice it,” said he. The varicose ulcers have healed up and the skin around is assuming a healthy hue.

Repeat jan. 8. Has had gatherings in the place where the black patch the place where the black patch was. All the varicose veins and varicocele much better.

Rx. Kali Chlorum, 6 trit 3iv. Four grins in water three times a day.

April 14. The veins are all getting smaller; the foot has completely healed (head had it nearly all his life!) The varicocele very much better, and also the varices of the lower extremities the venae saphenae longae having notably diminished in size. These few months of treatment have wrought a great change in the patient and in the man, and I accordingly gave him permission to get married. He is of course to get worried. He is of course not yet completely cured of his general varicosis, the time has been to short for that, – but the improvement is so great that all obvious unsightliness has disappeared, and this is no small boon to a man contemplating marriage.

This case has given me great satisfaction as a worse one has never come under my observation in man of that age. I made use of no local application whatever; neither was any change made either in his diet, mode of life (standing nearly all day) or place of abode, but he continued the bandage to his foot, to which he had been accustomed for more than twenty years.

He tells me his father suffered similarly. Practical men will agree with me that it is not very usual to have trouble from varicose veins at ten years of age, as this gentleman had, and that, as it went on without getting any better for twenty years, the present remarkable amelioration is, and can be, due to nothing else but the the medicines; and this being so – and considered in conjunction with the lamplighter’s case – my present thesis, that venous dilatation can be cured or ameliorated by medicines, is established. The basis on which it is established is narrow, perhaps, and therefore we will proceed to widen it by citing other evidence in its favour.

Before doing so, however let me be allowed to give what surgery has to say on varicocele. I will quote from a young promising surgeon, of the very latest date. In the Lancet of July 17, 1880, we read; PART OF A CLINICAL LECTURE ON THE RADICAL OF VARICOCELE BY THE GALVANIC ECRASEUR, DELIVERED AT THE WESTMINSTER HOSPITAL ON JULY 3RD, 1880, BY A. PEARCE GOULD, M.S., F.R.C.S., ASSISTANT-SURGEON TO THE HOSPITAL, AND LECTURER ON ANATOMY TO THE MEDICAL SCHOOL.

GENTLEMEN, Although there are very many cases of varicocele in which no treatment, or only palliative measures, are required, you will meet with others in which it will be your duty to undertake the permanent or radical cure of the varix. These cases are as follows :1. where the testicle is atrophying 2. Where the varicocele is double, especially if an examination of the semen shows an absence of spermatozoa, or the patient being married is sterile. 3 Where the opposite testicle is lost or useless from tumour orchitis, epididymitis, or injury. 4. Where the varix is large and increasing in spite of palliative treatment. 5. Where the varix causes much pain or interferes with proper exercise and necessary work. 6. Where it is occasion of marked mental depression. 7. Where the varicocele prevents acceptance for either of the Government services.

There are many plans for securing the radical cure of varicocele, including castration, excision of the veins the actual cautery, forcipressure, and ligature. The ligature is the method most commonly adopted and has been variously adopted and has been variously modified by Ricord, Vidal, Erichsen, Wood and H. Lee. (These methods of treatment were then described)

Of the efficacy of these treatment there can be no doubt but unfortunately they have no doubt but unfortunately they have two drawbacks the pain attending them, and a certain amount of danger. For a long time surgeons avoided as far as possible any interference with veins and although veins are now ligatured almost as freely as arteries there is no doubt that diffuse thrombosis, embolism, and septic poisoning are more liable to follow injuries of veins than of arteries. This being so, it is plainly the surgeon’s duty to avoid in every possible way any irritation or disturbance of an injured vein and it is because this principle is not sufficiently carried out that the usual modes of treating varicocele have been attended with serious and even disastrous results. The daily twist of Vidal’s pin, and constant traction of woods spring are not only painful but opposed to the great principle that demands perfect rest to all inflamed and injured tissues and veins in particular while in Lees operation, the presence of two hair-lip pins transfixing the scrotum is apt to set up oedema and inflammation and their removal is not without risk of embolism. That these are no imaginary fears is evident from the published results of these and analogous treatments. Gant says that the results of the operations are “variable,” and include diffuse inflammation and sloughing of the scrotum, suppuration of the testicle, phlebitis, pyaemia, and death Erichsen records two had deals from after ligature; Sir E. Hume had one nearly fatal case; Escallier mention two fatal cases of phlebitis, and curling speaks of three cases of serious years two of which were fatal. Some years ago the sensor of one of the chief London hospitals died from pyaemia after Lee’s operation. This list by no means includes all the accidents of these treatments it makes no mention of the pain suffered or of the inflammatory oedema and suppuration of the scrotum.

It was with the hope of avoiding these complications that I was led, now more than two years ago, to try the plan of subcutaneous division of the veins by means of a platinum wire heated to a red heat by electricity. The procedure is as you have seen very simple. First feel for the vas deferens and grasp the veins in front of it, and nip of the scrotum with the left thumb and forefinger; transfix the scrotum at this spot between the duct and the veins with a narrow bistoury and pass a needle armed with a platinum wire in the track of the knife; then return the needle through the same apertures, but this time in front of the veins between them and the skin. Of course if the vas happen to be in that of W. C.- shown to-day you modify the procedure a little. In this way you have the veins in a loop of the wire. It is better to make a puncture with a knife rather than merely to transfix with the needle for the veins are looped up cleaner there is not the same liability to include a portion of the skin in the noose as in the latter plan then attach the ends of th wire to the ecraseur, and connect with the battery, using sufficient cells to cause a faint hissing noise; one cell of Grove’s battery or at most two is sufficient. This step must be done deliberately; I have taken as long as five or six minutes over it. To protect the skin from burning let some cold water trickle over it while the wire is burning its way through the veins. The after-treatment consists in perfect rest in bed for a few days, with the scrotum supported on a broad strip of strapping fixed across the front of the thighs. I have three times operated without anaesthesia, but the pain may be severe, and I prefer to have the patient under the influence of either. After the influence recovery from the anaesthesia there is an entire absence of pain and this perfect freedom from spontaneous pain continues uninterrupted throughout the convalescence. A few hours after the operation the knobby feel of the varix is replaced by a soft even swelling which lessens and hardens and at the end of forty -eight hours is usually to be felt as a hard lump about the size of a big marble. This is tender on pressure. By the end of week it has lost its tenderness and has shrunk to three-quarters its original size. The veins below can still he full, but not compressible the blood in them has by that time coagulated, and they become smaller and firmer until ultimately a small pea-like induration in front of the vas is all that is left, and even this may disappear, and no trace of the varix or operation be left as in W.S —

James Compton Burnett
James Compton Burnett was born on July 10, 1840 and died April 2, 1901. Dr. Burnett attended medical school in Vienna, Austria in 1865. Alfred Hawkes converted him to homeopathy in 1872 (in Glasgow). In 1876 he took his MD degree.
Burnett was one of the first to speak about vaccination triggering illness. This was discussed in his book, Vaccinosis, published in 1884. He introduced the remedy Bacillinum. He authored twenty books, including the much loved "Fifty Reason for Being a Homeopath." He was the editor of The Homoeopathic World.