What is meant by a verified symptom? My answer has always been that when a drug has taken by a healthy person or number of persons and has repeatedly produced a certain symptom upon the one prover or upon a majority of a class of provers and then that remedy has been given to a patient presenting that symptom and caused it to disappear, that that symptom was a verified symptom, e.g., the dryness of the mucous membrane and dilated pupils of Belladonna. I have seen provers, to whom Belladonna had been given, fight like demons, and I have also seen patients who were fighting like demons (delirious) quickly quieted by the administration of Belladonna. The delirium of Belladonna ranks much higher than the dryness of the mucous membrane of that remedy because it is a mental symptom.
To me, however, the relation of a symptom to the others of the group in which it is found most accurately gives the rank of the individual symptom. To put it in other words, the knowledge of the tissue or organ involved and how involved, should determined the rank of the symptoms, i.e., we should know the source of the cause of the symptom.
Let us devote the remainder of our time to the study of vertigo for the purpose of demonstrating my method of studying a symptom. First let us get together on the word vertigo.
Definition: Hitzig says: “The perceptions of disturbances of normal ideas as to our bodily relation to space.” Dr. Palen, in Bartlett’s Practice, says: “Vertigo is a subjective sensation as a result of which one is unable to judge correctly of one’s position in space.” In Curschmann’s Clinical Neurology we read: “It is a specific, unpleasant feeling on the basis of conscious or feared disturbance of bodily equilibrium.”
The three words most frequently used as synonyms are dizzy, dizziness and giddiness
Ralph W. Leptwich, M.D., in his Index of Symptoms, page 84, gives over forty diseases (which I call groups of symptoms), in which vertigo may be and is a symptom. The tissue or organs include in these forty diseases are: blood and vessels, including the heart; brain, including the nerves; ear; eye; larynx; lungs; stomach; liver; kidneys; pancreas, and sexual organs.
Dr. Palen, in the third volume of Bartlett’s’ Practice, states that “Equilibrium, body balance, is preserved by three factors: (1) The ears; (2) vision; (3) the muscles, tendons, viscera.”
Again speaking of the source of vertigo, he says, “It may arise from (1) organic diseases of the central nervous system; (2) disease of the circulatory apparatus; (3) epilepsy; (4) hysteria; (5) peripheral irritation; (6) disease of the special senses; (7) toxaemia, and (8) from conditions which in the present state of medical knowledge are undiscoverable.”
I have nothing to add to the above it we include under toxaemia such conditions as malarial, remittent, and other fevers in which an extremely high temperature may be present.
The conditions found in the above-named tissues or organs vary from a simple irritation to the most profound structural change.
The number of remedies given in the index of our books on materia medica vary from five, as given by Wm. Boericke in his Materia Medica, to over a hundred and fifty, as found in Gentry’s Concordance.
Most writers on materia medica who use the schema from put vertigo under the section, head. This is a mistake. The word head is just as unscientific and unreliable for locating a tissue or organ as we have shown the word chest to be.
Keeping in mind our definition of a symptom, our classification of symptoms, especially that which we used to determine the rank of a symptom, and the source or cause of symptoms, let us now make a clinical application of the above given knowledge, using patients for whom Gelsemium was the indicated remedy, patients whose entrance complaint was vertigo, i.e., who come to us for relief from vertigo.
Case I. A healthy, well-built, light-haired attorney, aged 42, walked into my office and said: “Dr., I want you to cure me of my `dizzy’ spells. They began six months ago following a severe attack of Flu which was of the nervous form. You know I was down South on a hard case which nearly used me up, and on the day I was ready to start for home I was taken with chills up and down my back, a flushed face and aching in every part of my anatomy.
“There was no homoeopath in the place so I accepted the physician of the hotel at which I was stopping. I think he gave me quinine, in capsules, every three hours, after a good think of whiskey in a glass of hot water, and hot bottles were put about me to make me sweat; but I didn’t sweat. Yes, reading makes the spells worse, also a long heavy sleep, and I have many of them. Another queer thing about my reading, or my eyes, is that I see double. I cannot think as clearly as before the Flu. My legs tremble, all over. All other functions of the body are O.K.” Gelsemium 6th cleared up the paralysis of the recti muscle of the eye, cured him of his vertigo in four days and of his weakness, trembling and sluggish mind a little over four weeks.
Case II. A young woman, aged 22-sister of a woman whom I had cured of epileptiform convulsions coming at the menstrual period, came to my office and said: “My sister sent me to my you to have you cure my dizziness. It troubles me only at the time of my menses, at which time I have some sharp pain in the pelvis, a dull pain in the back of my head and up over the head; the head feels very full and large. Sometimes I feel faint when the dizziness is worse. I am afraid I’ll fall in the school room or that my pupils will think I am intoxicated.” Worse or better? Always worse if the menses are late or the flow scanty. Gelsemium 30th, five drops four times daily before the date of the menses cured her after the third period. The condition had existed for over six years.
Case III. Male, are 50. In the fall of 1883 a man was picked up on the streets of Des Moines as intoxicated and taken to what was then used as a hospital, after it was proven by his breath that he was not drunk. As I was the one who had last registered in the city the case was turned over to me. At 6 P.M. the temperature was 105.6; the pulse slow, full and soft; face a dark purple, besotted; the eyes closed; completely unconscious. The nurse said that he had both voided and defaecated involuntarily since being brought in two hours before. He was given Gelsemium 3rd, five drops every hour.
The next morning at 8.30 I was surprised to find not only that he was alive, but sitting up; rational, with temperature 100.3, face yellow, lids heavy.
He admitted he was a tramp who had come from southern Louisiana. He also said he had been in a hospital in the south and treated for remittent fever. Gelsemium was continued every three hours. He continued to improve and the next morning was normal, except that he was “dizzy” when he attempted to walk. He also “trembled in every part of my body.” Temperature 100. Because of the vertigo he was permitted to remain in the hospital. At 4 that P.M. I was recalled, and found the same conditions which existed at my first visit, except that the temperature was only 105.1. The nurse reported that she had heard a noise and on going to his room had found his unconscious on the floor, between his chair and bed. The Gelsemium was resumed every hour. It was ten days before the patient was normal and the vertigo was the last symptom to disappear.
Case IV. Male: teacher in high school, family and personal history good; said: “Doctor, you know I’m prohibitionist and never drank an ounce of liquor in my life, but I’ve been so dizzy for the past three days I can hardly walk.” Other symptoms? “Had a heavy catarrhal cold three weeks ago. It began in nose with sneezing and worked down; tongue coated heavy yellow; some nausea; to vomiting; no thirst, dark yellow mucous stools, diarrhoea; painless. The only pain or ache I have is a dull feeling over my liver.”
Examination showed an enlarged liver, yellow sclera of eyes and a slight tingling of the skin. Gelsemium 3rd, five drops every three hours promptly cleared up the case.
Case V. An old tabetic patient walked in one day, led by his son with “Doctor, you know I could not walk or even stand with my eyes shut! Well! Today I can hardly stand and cannot walk with my eyes either open or shut because I am so dizzy. On! In other respects there is no change, except that I have lost control of both bladder and bowels.” Fifteen minutes’ quizzing failed to make him say that he knew any cause for the condition. Finally the son motioned me into another room and told me that, three days before, his brother (the patient’s son) had been arrested, found guilty and sentenced to prison for ten years. The news had caused such a shock that his father had gone “to pieces.”
Gelsemium 30th, three doses of five drops, daily, checked the “vertigo with eyes open or shut” and the abnormal stools. This in 48 hours, but it did not help the “vertigo with eyes closed.”
Numerous other cases could be cited in which “vertigo” was the center of different groups of symptoms, but these five are sufficient to illustrate my method of studying a symptom. Therefore, let us close by reviewing these five cases.