May 24th. Patient writes me that he has obtained, without difficulty, a situation in a store, and that he is no longer conscious of being deaf. His sole difficulty is that, as he has the reputation of being deaf, everybody shouts at him. His father writes that the sons hearing is “perfectly restored”.
REMARKS. The success of the treatment resorted to in this instance warrants a few remarks upon its rationale. Here was a case which presented to the practitioner apparently nothing on which to base a prescription. There was a thickened membrane tympani-nothing more.
The work of thickening had probably been accomplished years ago. Here was a pathological-anatomical condition,but no pathological process and, consequently, there were no abnormally performed functions- or in other words, no symptoms of disease-from which to draw indications for the treatment. The pathological-anatomical condition threw no certain light on the pathological process which had produced it-just as a knowledge of the town, at which a traveller has arrived, gives no certain clue to the road by which he reached it.
But, as Hahnemann advised his disciples, the history of a case.
is often of the utmost importance in determining the treatment. In the case before us the coincidence between the violent removal of the tinea capitis by nitrate of silver, and the appearance of the deafness, was too marked to escape notice. It could not fail to occur to the practitioner that the scalp disease was one phase of a psoric affection, as Hahnemann would have called it, or of a dyscrasia, as the modern school of German pathologists would say (for the doctrine of dyscrasias is but a rehash of Hahnemanns psoric theory), and that this affection, disturbed in its localization upon the scalp, had transferred itself to the tissues of the ear.
It further occurred to me that, since in this latter localization there were no sufficient indications for a prescription, I might find such indications in the phenomena of the former localization upon the scalp. I accordingly addressed myself to the task of getting a complete picture of this affection, which had disappeared thirteen years before.
By good fortune the mother of the patient was possessed of a good memory, and of very excellent powers of description, and from her I learnt that “thick, whitish scabs, hard and almost horny, covered the whole scalp. There were fissures in the scales, through which, in pressure, there exuded a thick, yellowish pus, often very offensive. There was great itching, and a disposition to tear off the scabs with the finger-nails-especially troublesome at night”.
The remedy which corresponds most closely, in its pathogenesis, with the above group of symptoms, is undoubtedly Mezereum. In the introduction to the proving of that drug, in the Chronic Diseases, Vol. IV, Hahnemann recommends it for moist eruptions of the scalp.
In the proving, in the Archiv., Vol. LV, many symptoms point to a similar eruption-itching, especially at night, but the conclusive group of pathogenetic symptoms is the following, from a new proving of Mezereum, by the late Dr. Wahle, of Rome, of which the manuscript was shown me by his son, the present Dr. Wahle. .
“Head covered over with a thick leather-like crust, under which thick white pus collects here and there, and the hair is glued together; on the head, great, elevated, irregular, white scabs, under which pus collects in quantity, and becomes offensive and breeds vermin. The child keeps scratching its face and head at night, and continuously tears off the scabs”.
The resemblance between these groups of symptoms was so striking that Mezereum was at once selected as the remedy for this case of deafness, just as if the scalp affection had been still in its original form, and has been the immediate object of the prescription.
It not infrequently occurs that we are called upon to prescribe for what seem rather results, of morbid actions, than active diseases. In such cases it would seem that we may often successfully base a prescription upon the symptoms of a diseased condition which no longer exists, but which form, in reality, a part of the case.
It may not be amiss to call attention to the completeness of the corroboration which this case affords (were any needed) of Hahnemanns psora theory. It is hardly necessary to say that Hahnemann had no idea or restricting psora to itch, as we understand that term, that is to the disease caused by the acarus. On the contrary, in his Chronic Diseases, Vol. IV, he expressly includes under it various forms, as “Itch, Tinea Capitis, herpes, etc.
BLACK LETTER SYMPTOMS.
Hypochondriac and despondent. Takes no pleasure in anything.
Everything seems to him dead, and nothing makes a vivid impression upon his mind.
Very violent HEADACHE : head painful to slightest touch (after a slight vexation).
Bone pain in bones of skull, especially aggravated by contact.
Cranial bones pain,. are swollen and sensitive to cold and contact : worse from motion and in the evening. Caries.
Itching and burning of SCALP.
Head covered with a thick leather-like crust, under which thick white pus collects here and there, and hair is glued together.
On the head, great elevated white scabs,under which ichor collects in quantity, and which begins to be offensive and to breed vermin.
EYES : sensation of dryness.
Obstinate jerking of the muscles of left upper lid.
EAR : Sensation of air distending the external meatus. (Then left.).
TEETH feel blunt and elongated : painful on biting or from fresh air.
Violent burning in mouth.
Heat and scraping in fauces.
Burning in THROAT and pharynx : dryness in fauces, hacking cough; anxious oppression of breath, loosening of scanty mucus on coughing.
Vomits BEER, which has a bitter taste (not water).
Pain in periosteum of long BONES, especially tibia : worse at night in bed ; least touch is intolerable. Worse in damp weather.
Bones inflamed, swollen, especially shafts of cylindrical bones; after abuse of Mercury and venereal disease.
Eczema, itching intolerably, copious serous exudation.
Neuralgia and burning after zona.
The SKIN of face is of a deep inflammatory redness, and the eruption is “fat” and moist.
The child scratches the face continually; it becomes covered with blood.
In the night the child scratches its face so that the bed is covered with blood in the morning; and the face is covered with a scab which the child keeps constantly tearing off anew, and on the spots thus left raw, large (fat) pustules form.
Ulcers covered with thick whitish-yellow scabs, under which thick, yellow pus collects.
Vesicles appear around the ulcers, itching, violently and burning like fire. After eight days these vesicles dry up, leaving scabs, the tearing off of which causes great pain and retards healing.
SOME QUEER, OR ITALIC SYMPTOMS .
Irritable; averse to everything; desire to run away. (Bell., etc).
Apprehensiveness in pit of stomach (K. carb., etc.) as when expecting some very unpleasant news.
Everything vexes him; he wants to say all kinds of annoying and vexatious things.
Unable to recollect : or understand. Every intercurrent remark of others disturbed and confused his ideas.
Head dull, as if intoxicated : as of he had been up all night.
Headache from root of nose into forehead as if everything would press asunder.
On pressing frontal bone it pains and draws down to the feet.
Heat and perspiration on head; chilliness and coldness in rest of body (morning).
Sensation upper part of head, as if pithy.
Pressing pains as if skull would split.
On head, great elevated white scabs : chalky scabs, extend to eyebrows and nape of neck.
Violent biting on head,m as if from lice.
Pressure in eyeballs, as if too large.
Moist, itching eruption on head and behind ears. (Graph.).
Dry eruption on head, with intolerable itching, as if head was in an ants nest. (Favus.) (A case of favus cured recently with puls.-in a typical pulsatilla child.-ED.).
Eczema of lids and head; thick hard scabs, from which pus exudes on pressure.
Ears feel as if too open, and as if air was pouring into them; or as if tympanum was exposed to cold air; with desire to bore with finger into ear.
Oozing eruption behind ears.
Fluent coryza, scabs in nose-soreness. Constant excoriation of nose. (Compare Aur., Sulph.).
Facial muscles drawn tense : troublesome twitching of muscles of right cheek.
Feeling as if eyes were drawn backward into head. Wind blowing in the right ear.
Honey-like scabs about mouth.
Sensation as if tooth was being lifted out of socket.
Teeth decay suddenly above gums; crowns remain intact.
Decaying roots.
Peppery sensation on palate and in fauces.
Canine hunger noon and evening. Loss of appetite.
Desire for ham fat, coffee, wine.
Beer tastes bitter and causes vomiting.
Burning in whole mouth as from pepper.
Ulcer of stomach.
Induration of stomach.
Burning, corroding pains in stomach, as if it were raw inside.
Stool contains glistening bodies. Small,white, shining grains in brown faces.
Anus becomes painful and constricted about fallen rectum.
Dr. Dunham graduated from Columbia University with Honours in 1847. In 1850 he received M.D. degree at the College of Physicians and Surgeons of New York. While in Dublin, he received a dissecting wound that nearly killed him, but with the aid of homoeopathy he cured himself with Lachesis. He visited various homoeopathic hospitals in Europe and then went to Munster where he stayed with Dr. Boenninghausen and studied the methods of that great master. His works include 'Lectures on Materia Medica' and 'Homoeopathy - Science of Therapeutics'.
