On October 10, 1864, I was requested to visit Mrs. C. E. H., aged about thirty- eight years. She gave me the following history: She had been always in good health, married ten years, but never pregnant. While traveling in France in
1854, she was attacked with what was then called acute peritonitis. She was confined to her bed several years. Partially recovering, she consulted Trousseau, who discovered the right ovary inflamed and somewhat enlarged. From this time she was more or less unable to walk, and suffered much from a tumor, which gradually developed in the pelvis, between the uterus and the rectum, and which was pronounced by Trousseau to be an enlarged and prolapsed ovary.
In 1863 she came to New-York, and placed herself under one of our most experienced gynecologists, who confirmed Trousseau’s diagnosis, pronounced the case incurable, and advised a sparing resort to anodynes to mitigate severe suffering. I found Mrs. H. confined to her sofa; she had not left her room for a year. A firm, elastic tumor occupied the space between the uterus and vagina anteriorly, and the rectum posteriorly, completely occluding the vagina, and rendering defecation very difficult. it seemed not to be adherent to the walls of either passage. Attempts at walking induced paroxysms of acute pain across the hypogastrium, in the sacral region, and around the hip-joint; from here the pains extended down the groin and along the femoral nerve. The pain was relieved by flexing the thigh upon the pelvis; and always induced or aggravated by extending the thigh. Even without the provocation of motion there were frequent and severe paroxysms of pain, as above described. The appetite was not good, and digestion feeble; but the general condition of the patient was good. Nervous sensibility was very great. The pains had been ascribed to the pressure of the tumor upon the sacral nerves.
The patient had a dread of taking opiates, and had used them sparingly. I was requested to mitigate the pains, if possible, no hope being entertained of a cure. With no definite expectations of accomplishing a radical cure, I prescribed Colocynth 200; a few pellets to be taken whenever a paroxysm of pain came on, and to be repeated every hour during the paroxysm. This prescription was based on the results of the Austrian proving of Colocynth, which confirm and amplify the provings of Hahnemann.
November 1. I learned that the paroxysms had been less frequent, much shorter, and milder; the remedy appearing to control them.
March 1, 1865. The patient walked half a mile to my office and reported that she had had no pain for a month. She could walk half a mile daily without fatigue or pain, and had resumed the charge of her household after an interval of nine years. She thought the tumor had become somewhat smaller. Being about to sail for Europe, she desired some more Colocynth, that she might be provided in case pain should return.
June 9, 1869. Mrs. H. has just arrived from Europe. I find her perfectly well. There has been no return of pain since 1865. The tumor disappeared from its position between the Vagina and rectum in the autumn of 1865, and was plainly perceptible in the abdomen, about as large as a Sicily orange. It has since disappeared entirely, and nothing of the kind can now be discovered. Was this really an ovarian tumor? No doubt appeared to be entertained by the eminent physicians who preceded me in the case. Did the Colocynth cause its absorption? The patient has no doubt on this point. Why should it not have done so? Because we have no record of any action of Colocynth, except on the intestinal mucous membrane, and on certain plexus of nerves? Fortunately, the action of remedies is not restricted to the measure of our imperfect a priori knowledge of them.
A reviewer in the British Journal takes exception to a statement of mine, that a remedy, when indicated by a well-marked group of symptoms, will often remove, not merely those, but also other groups apparently unconnected, in fact, the whole diseases. This case is in point. And yet I can hardly doubt that, in such cases, a complete proving, were it possible, would show that the remedy does produce likewise these seemingly unconnected symptoms, in fact, a picture of the whole disease. Indeed, on examining the Austrian proving, we find Frolich reports two brief provings on women, both of which show the action of Colocynth on the ovaries. Had we well-instructed women-provers, how much more we should know of the action of drugs!.