FEVERS AND BLOOD-POISONING.
HAD the homoeopaths done nothing in practical medicine but fix and precisionize the use of Aconitum in inflammations and fevers of the inflammatory kind, they would have well merited the undying gratitude of the whole human race. That the use of Aconite is thus by them fixed with scientific precision is a matter of common knowledge, and needs no further insisting upon, for “we do not drink our Aconite out of a Wilksian mug.”
But while this is a fact, while we thus have inflammatory fever, as it were, under our thumbs, we have heretofore had to deal with typhoid and other continued fevers from blood-poisoning in quite a different manner.
Granted that Aconitum is no mean remedy even in these continued fevers, still it will not regulate them or shorten their course, though it will ease them, and will even do a good deal towards rendering a mild case milder, perhaps through the diaphoresis.
Granted also that Baptisia tinctoria will do much good in some cases of continued fevers, perhaps even regulate some gastro-catarrhal cases, still, from a good deal of experience, I can say that it is at best a long way from having a real control over the continued fevers I have met with.
The allopathic treatment of continued fevers is hopeless helplessness: the patients just live or die according to the ratio of the dose of fever-cause to their body-bulk, and (the dose not being of necessity lethal) in proportion to their powers of resistance, and modified by hygienic surroundings. Of course no system of therapeutics can be of any service where the causal quantity is necessarily fatal right off. “Nursing” is their sheet-anchor!
In modern modish medicine it has come to this state of despair in the treatment of continued fevers. This I have seen in the best hospitals in Europe, and under the best allopathic physicians modern times has produced. I will not deny but that judgment and care, and some clever clinician’s resourcefulness, will at times save a given case at a collateral crisis, but this is all that can be truthfully conceded.
Hydropathy does some good in continued fevers, but its help is not very certain.
Homoeopathy has hitherto won but few real laurels from its successes in continued fevers, though with the aid of Baptisia, Arsenicum, the serpent poisons, Mercurius, Gelsemium, Aconite, Phosphorus, and many other more or less symptomatically or hypothetically indicated remedies, the homoeopathic practitioners get the best results yet obtained, and bad they are. No one of the remedies used will, even theoretically, cover the whole case.
To conduct a case of typhoids to its termination, we often need the aid of a dozen different remedies for the different symptoms and syndromes as they arise, and then the patient will often die at the end, either of diarrhoea and haemorrhage, or otherwise. And I do not here refer merely to cases amongst the very poor, or under bad or indifferent hygienic surroundings, but to cases in the wealthy classes, with excellent hygienic surroundings, capital nurses, and clever physicians of the most advanced schools of medical thought, and all anxious to do their best.
The fact is, continued fevers are our masters, and we can, even with homoeopathy, good nurses, good hygiene, and “the best of everything,” only fight the enemy in detail symptomatically or hypothetically. And we thus mitigate the course of the bulk of the cases, and save the lives of a few who, but for our aid, might have succumbed. That homoeopathy may be proud even of these achievements I will not deny, but they are not good enough when all put together to make a nice pillow to sleep on. Rather should they fill us with humility and discontent, and stir us all up to find something better.
I was in this frame of mind when Dr. Drysdale in and just before the year 1880 brought forward a suggestion that Pyrexin might be a good remedy in typhoid and synochus generally. But the dose and mode of administration were stumbling-blocks to me: I did not feel I should like the treatment for my own person, and so I turned away from it not without some feeling of disgust. And, as it is an axiom with me never to give another person a remedy that I would not myself be both willing and anxious to take were I similarly, I thought no more of Pyrexin as a remedy.
Time passed, and occasional cases of continued fevers- typhoid-came under my sole care or in consultation with other physicians, but I did not cure them, nor could older and more experienced men whom I called to my help. The most experienced and most eminent homoeopathic physicians in London kindly saw two consecutive cases very frequently with me; their treatment and mine were practically the same, and also their results-both patients died after a number of weeks of detail treatment that time and again seemed to be curing the cases.
But we evidently only cured the symptoms and syndromes-the morbid process was going on within undisturbed in its essential course and progress; the various remedies only acted, as it were, at a tangent, none were adequate, so I made up my mind to go in quest of some better treatment for any future cases that might fall to my lot, and Dr. Drysdale’s Pyrexin seemed to stand in the way. Before going further afield, I thought it best to try the pyrexin: there are strong theoretical grounds for its use in Pyrexin quite apart from Dr. Drysdale’s results, which “have been favourable and give good promise” (p. 16).
Mr. Health, of Ebury Street, very kindly made a preparation of the remedy according to Dr. Drysdale’ direction (*”On Pyrexin or Pyrogen as a Therapeutic Agent,” London: Bailliere, Tindall, & Cox, 20 King, William Street, Strand, W.C., 1880.* by John Drysdale, M.D.*), and it was carried up to the sixth and twelfth centesimal dilutions and kept ready for my use.
Before I go in to my experience with pyrexin or pyrogen, I think it would be useful to quote from Dr. Drysdale’s paper; the style is so concise that I cannot advantageously condense the part I want, hence it shall follow in full. Drysdale says,-
“In studying the experimental evidence bearing on the germ theories of disease, I was greatly struck by a remark made by Dr. Burdon Sanderson in the British Medical Journal of 13th February 1875. It was as follows:- `Let me draw your attention to the remarkable fact that no therapeutical agent, no synthetical product of the laboratory, no poison, no drug is known which possesses the property of producing fever.
The only liquids which have this endowment are liquids which either contain bacteria, or have a marked proneness to their production.’ This last clause is qualifies by the statements elsewhere, and from other sources, that the fever producing agent is a chemical non-living substance formed by living bacteria, but acting independently of any further influence from them, and formed not only by bacteria but also by living pus-corpuscles, or the living blood- or tissue- protoplasm from which these corpuscles spring.
This substance when produced by bacteria is the Sepsin of Panum and others, but in view of its origin also from pus, and of its fever-producing power, Dr. B. Sanderson names it Pyrogen. If, however, it is to be also used therapeutically, I suggest the more neutral name of Pyrexin. I cannot admit without qualification the statement that no drug of poison can produce fever, for undoubtedly Aconite, Belladonna, Arsenic, Quinine, Baptisia, Gelsemium, and a host of other drugs, do produce more or less of the febrile state among other effects.
But they produce it only after repeated doses, and contingently on the predisposition of the subject of experiment, and thus uncertainly as regards any individual case or dose; or they produce it as a part of a variety of complex local and general morbid states, of which it may be a secondary phenomenon. It is therefore practically true that no other known substance induces idiopathic pyrexia certainly directly, and at will after a given dose. This directness and certainty of action ought to make it a remedy of the highest value if it ever can be used therapeutically; and if the law of similars is applicable here as it is in so many other instances, we ought to find it curative in certain states of pyrexia and certain blood-disorders to which its action corresponds pathologically.
In order to put this suggestion to the test practically, let us first shortly sum up the symptoms and pathological changes caused by Sepsin or Pyrogen freed from all bacterial, self-reproductive, or transmissible cause of disease. In a series of experiments by Dr. B. Sanderson on dogs after a non-fatal dose of Pyrogen (i.e. 1 I/4 cubic centimetre of the aqueous solution per kilogram of body weight, or I/2 grain of the solid extract for an ordinary sized dog), the animal shivers and begins to move about restlessly; the temperature rises from 2 degree to 3 degree C., the maximum being reached at the end of the third hour.
There is great muscular debility; thirst and vomiting come on, followed by feculent and thin mucous, and finally sanguinolent diarrhoea and tenesmus. These symptoms begin to subside in four or five hours, and the animal recovers its normal appetite and liveliness with wonderful rapidity. I mention this fact as proving that the septic poison has not the slightest tendency to multiply in the organism; and secondly, as rendering it extremely probable that when death occurs it is determined not so much by alvine disorders, which are so prominent, as by the loss of power of the voluntary muscles and of the heart. (*Brit. Medorrhinum Fourn., ii., p. 913.*).