Mrs. H. C., aet. 42; widow. Has eruption on legs, which burns and itches, and is worse from warmth of bed. She cannot keep her legs quiet at night. Is worse from warmth of stove, which causes creeping sensation over whole body. Feet are icy cold during day, but soles burn at night in bed.
Lameness of left shoulder, which has lasted since rheumatism four years ago; this is worse when lying on it. The hands go to sleep and feel numb, more specially the left one. The wrist pains as if sprained when awakening. All pains are of burning character and change locality often and suddenly.
Sometimes, there are small ulcers on inner side of left thigh, from which there is a thin offensive discharge; walking will cause them to smart, become red and puffy. Stiffness in small of back on bending or beginning to move. The pains go down the thigh. She has dry cough, which is worse after sleep and is caused by a tickling in the throat. This cough has always come the last of March or the first of April, and would last until real hot weather had come; with this cough she is quite hoarse and has sensation of lump in the throat. Menstruation is dark and scanty and offensive; has not been regular since last child, twelve years ago; she says all her aches and pains are better during her flow, and she never feels so well as when flowing freely, although it is sometimes accompanied by a painful diarrhoea. At other times she is always constipated; has to closet and try several times before she has stool. There is sensation of weight and pressure in bowels with much rumbling of gas. Abdomen is sensitive in the morning on awakening. Complains of burning, stitching pains in left ovary when constipated. Appetite one time is good, then she may have none at all. She says she cannot get enough to drink; has constant thirst and drinks a great deal of coffee. The mouth and tongue are dry; has feeling as if the skin was peeling from the roof of mouth. Sour taste in mouth all the time; tongue cracked, brown center and red tip.
Does not sleep well; has had work to get to sleep before midnight and then she wakens frequently with shock in pit of the stomach and a tight suffocating feeling in the chest. Lately she has complained that her heart feels too large for her chest when she walks fast. This oppressive pain is sometimes relieved by belching. For past few weeks face and lips are bluish; has flushes of heat, but only one cheek gets red; the other is pale. For last year her hearing has been failing; she complains of noise like a tea kettle boiling. There has been scarcely any wax, and what there was would be hard and white. Riding in the cold has always given her earache. She fears to go to bed during this last attack, as she thinks she may die, and she says she dreads to die so much.
There has always been more or less headache, at different times, but the one which has been most troublesome is one that begins on the right side of head and goes through to the left until it aches all around. With this there is a drawing in the back of neck and burning pains back of the eyes; some dizziness with sensation as if she were going to fall to the left side. She has an irritable disposition and everything seems to be worse in the morning when she awakens.
Now what is the diagnosis in this case? I do not know. Have never made one. We do no care about the diagnosis, as it is not a disease we wish to treat, but rather this sick woman we are going to try and cure. We have a well taken case, and from this mass of symptoms we must select some that will individualize this case and make it different from all others. Let us look at the record and see which symptoms we will select for our repertory analysis. We find the following general symptoms:
Worse after sleep, thirsty, burning pains, left side and better during flow. Making a repertory analysis of these we find under:
Worse after sleep. – Aconite, Apis, Arnica, Arsenicum, Camp., Carb. s., Carb. v., Causticum, Chelidonium, Cocc., Conium, Euphrasia, Ferrum, Hepar, LACH., Lycopodium, Opium, Phosphorus ac., Pulsatilla, Rheum, Sabad., SEL., Sepia, Spongia, Staphysagria, STRAM., SULPH., Veratrum
Thirsty. – ACON., Arnica, ARS., Camp., Carb. v., Chelidonium, Cocc., Conium, Hepar, Lachesis, OP., PHOS., STRAM., Sulphur
Burning pains. – Aconite, Arnica, ARS., Carb. v., Conium, Lachesis, Opium, PHOS., SULPH.
Left side. – Arnica, LACH., PHOS., SULPH.
Relieved during flow. – LACHESIS.
Here you see we have worked our long case down to one remedy with five rubrics. We will now turn to the pathogenesis of Lachesis and see if our selection has been justified. In the Guiding Symptoms we find under Lachesis not only the five symptoms we have used, but also each and every one of the other symptoms; so this remedy must be homoeopathic to the case.
Lachesis, two powders, was sent with the following results: For thirty-six hours after the administration there was an aggravation of all the symptoms, which was followed by rapid improvement that has continued ever since until the last report, when she wrote that every symptom had disappeared and that she felt as well as she had ever been in her life.
Let us look at the analysis of constipation, the great bug-bear of our prescribers, who say that constipation cannot be affected by the homoeopathic remedy. The reason for this statement is that constipation, in the common, per se, cannot be cured, for we have no one remedy for the disease condition.
Even when we bring our case of constipation down one step in individualization we are no better off; taking for example, constipation with hard stool, under this common general we find eighty-three remedies listed under this rubric (page 635, second edition, Kent); any one of these remedies might be curative in such a general condition, but if we do not have something to individualize our case further we are at sea.
Taking the character of stool as:
Stool Dry (page 634). – We narrow our list to thirty-one remedies, which are as follows: Aesculus, Ammonium c., Argentum m., Argentum nitricum, BRY., Calcarea c., Cimex., Conium, Cuprum, Hamamelis, Hepar, Kali bichromicum, Kali carb., Kali sulph., LAC. D., LYC., Natrum mur., NIT. AC., NUX V., OP., PHOS., Platina, Plb., Podophyllum, Prun., Sanicula, SIL., Stann., Sulphur, ZINC.
With this condition is often associated inactivity of rectum, i. e., not having a desire for stool for three or four days.
Inactivity of Rectum (page 619). – We find fourteen of the above thirty-one remedies, in the first and second grade, which allows us to narrow our group of curative remedies to the following: BRY., Calcarea c., KALI C., Lycopodium, NAT. M., NUX V., OP., PHOS., Platina, PLB., Podophyllum, SANIC., SIL., Sulphur
The stool may crumble, and if such is the case it will help you to further particularize the above fourteen remedies in order to find the one curative remedy in this individual case.
Crumbling (page 634). – This rubric gives us only five out of the above fourteen which have crumbling stool, and are as follows: Natrum mur., Opium, Platina, Podophyllum, Sulphur
The best we have been able to do with the symptoms that refer to the constipation, per se, has been to narrow down to five remedies, and one of these five will be curative. You say we might give all five at once in a gun-shot prescription, and that is what some men do, and then say that Homoeopathy will never cure constipation. Or that you might give first one and then the other in rotation, but you would never cure the case that way, although one of these five remedies will be curative if given alone. We must look for other symptoms of the patient, and you will always be able to find some in every case that will help us to individualize this patient so we may find the one remedy.
Suppose Burning pain after stool. (p. 624). We find that this rubric only contains Natrum mur, and Sulphur of the above five remedies. We are now down to two remedies either one of which may be curative. Look at the tongue, and see if you cannot find some symptom there which will help you out. Let us suppose that this patient had a heavily coated tongue, but along the edges there were spots which were clean. This would be known as mapped tongue. Look under this rubric, Tongue mapped in circles on sides (page 411). We find that of our two remedies only Natrum mur, has this symptom, so if you have no marked generals to rule out Natrum mur, it would be the remedy and would cure the case, unless there was some tissue change or growth which from pressure was causing an occlusion of the bowel. In taking these old cases of constipation do not expect to give one dose, or a dozen doses, in rapid succession, and expect the constipation to disappear over night or in a week. These cases are usually long standing, they all have the constipation habit, and most of them the cathartic habit, and have to be carried along with your remedies in series, mayhap for several months, before a cure will be established.
In order to cure your case you must insist upon the cathartics being stopped at once, and until your remedy has changed conditions so as to establish a normal stool you must depend upon diet and an enema of warm water to empty the lower bowel.
