Let us now take a second case to show that one may be far more difficult than another in many particulars. Case II. Miss Carrie B., aged 26; school teacher; five feet seven inches tall; weight 118; brown hair; skin neither dark nor light, came into the office and dropped into the chair with, “Doctor, I have come in to see if you could give me something to prevent my taking cold on the least provocation. I’m so sensitive to cold. My pupil, Fannie J. (Case I), told me you cured her.”
When asked what was the result of her taking cold, she remarked, “Oh! everything.” The reply was in an irritated, disgusted, discouraged tone of voice. “Sometimes I have a sore throat with sharp, sticking pains at first, then later a sticky mucus, which is hard to get up or down; this mucus is always worse from three to six A.M., when it often wakes me up; sometimes the cold goes to my liver and my side gets sore and I have sticking, stitching pains over the liver; and my abdomen bloats hard and then constipated and light colored.
In either case, the stools are painless. And then again the cold may go to my female organs so that the menses are delayed and accompanied by the same pains that I have in my throat and side, or I may flow like a river. I’m in that condition now. After these cold, I’m weak, good for nothing. An irritable, so much so, that the pupils have complained to the principal.”
When asked about her family and personal history, she replied, “I’m just like dad. He is fifty and has been cross and irritable ever since I was old enough to remember. He is always grunting about his `poor liver.’ His mother died of cancer of the liver at the age of sixty five; about two years after the cancer was first discovered.
Mother and her folks are O.K. She is healthy and her ancestors all lived to be over seventy-five.” As no remedy came clearly to mind in this case, I took down Gentry’s Concordance, and turning to page 789 of Vol. VI, found the following: “Tendency to take cold easily. Magn-m., Natr-c., Natr-m., Nitr- ac., Nux-v. (Calcarea-c., Kali carb., Phosphorus, Sulphur, Silicea), also tendency or liability to take cold. Coni., Graphites” This gives us a class of remedies and constitutes the first step. The second step was to determine which remedy of this class most closely resembles the patient in make-up and other symptoms. For this purpose I most frequently use, and did for his case, T.F. Allen’s Handbook of Materia Medica of J.H. Clarke’s Dictionary or both.
We find a excellent description of the first case in Allen’s Handbook, page 235, under clinical; also in Clarke’s Dictionary, page 388, of Vol. I. Kent gives us a most striking resemblance of the first patient’s make-up in his Materia Medica, page 297.
Let us now take up the most important part of the first patient’s Entrance Complaint, viz., the menstrual and leucorrhoeal flow. For this, see Allen’s Handbook, page 241; Clarke’s Dictionary, Vol. I, Page 348; Kent’s Materia Medica, page 310; Boericke’s Materia Medica, page 168.
Again, let us now take up in similar manner the Entrance Complaint and make-up of Case II. The condition for which both sought relief was the same viz., menorrhagia caused by taking cold. But the make-up was very different. As stated, I decided on Calcarea for the first case at first sight. Calcarea carb. is a very easy drug to study, while Kali carb. is as difficult as the other is easy.
As a result, I was unable to decide on which of the remedies in Gentry the patient most resembled. Recalling that Kent had said something about Kali carb, being a hard remedy to study, I took down his Materia Medica, and on page 586 I read the following: “The Kali carb. patient is a hard patient to study, and the remedy itself is a hard one to study.” Then rapidly running my eyes over the twelve pages and taking a few of the symptoms, which were in italics, such as “irascible,” “irritable to the very highest degree,” “sensitive to every atmospheric change,” “Sensitive to cold.” “symptoms come on at two, three or five o’clock in the morning; and internal hemorrhages,” I decided upon Kali carb. as the remedy for my patient, Case II.
This question settled, another arose, viz., potency and repetition of the dose? This question I answered “Yankee” fashion by asking myself another question, viz., What am I expecting to do for the patient? Cure her? Relieve her condition? or simply prolong life? My experience with this case of patients has taught me that to be able to make a complete cure is the exception. My experience with Kali Carb. refreshed by these words in Kent, viz., “Kali carb. fits just these symptoms alone and dose not fit the whole constitution of the patient (page 593),” made me decide that the remedy would only be palliative; that it would act best in a low potency, the 6th, and should be repeated before each of the three meals and at bedtime.
As the medicine with directions were handed the patient, she said, “Now, what am I to expect? Are you going to cure me?” She was told that there would be a decided improvement in every respect but that I could not promise more. She was also asked to report in person two weeks after the next menstrual period. The record shows the following: “No, have taken no fresh colds; no, did not flow as much as the time before; there was less pain in the bowels and region of the liver; and I sleep somewhat better; no, I am not better every way, for I am more irritable and snappish than ever, and I cannot feel that I am any stronger.”
Changed the Kali carb. from the 6th to the 30th, five tablets morning and evening, and asked her to report again there weeks after the next period, which she did as follow: “Took cold two weeks ago, but this time it went to my throat, the menses came twenty-six days after the others, only lasted four days, and there was less other trouble with them; no, am not quite so weak but far from strong. I thought I was better natured till this cold came, but since then have been crosser than ever. Tell you all about my throat? Why, I told you all that before.” The last she snapped out as if I had insulted her by my question. I then took down her former record. Examination of it showed the submaxillary glands slightly enlarged, the uvula elongated are relaxed; mucus back of uvula, and the entire larynx covered with thick, stringy mucus.
The pharynx was similarly involved and there was a constant hacking and spitting of the mucus. The present condition was the same.
Kali carb. 30th was continued, five tablets in the morning before breakfast. She was also given some tablets of Pix Cresole and told to dissolve one in a teacupful of hot water and gargle the nose and throat with the solution morning and evening.
Five weeks later she again reported: “Those little, yellow gargle pills worked like a charm. That attack of sore throat cleared up at once and about a week ago, after a little cold, the throat trouble started again, but those pills checked it by using them these times.
“Oh! yes, the menses came after twenty-four days and were what I would call natural in every way; my stomach and bowels are better, have less indigestion, and the stools are more normal and regular. “Yes, I do need more medicine. I want something to help me in the home and schoolroom; am crosser and more irritable than ever.”
She was given Placebo, two doses daily, and asked to report in four weeks. She returned in ten days, saying, “Doctor! I’m desperate. My pupils have complained again to the principle and he has just had me on the carpet. If you don’t help me, I’ll lose my place.” “Have I been worse mentally?” “Yes, I have. In addition to being cross and irritable, I have been snappish, impatient and intolerant.
I can’t bear any noise nor anything else. i saw a boy throw a spitball at a girl, and I took him by the hair of the head and swept the floor with him. His mother went to the principal and then he called me down. It was the second time. The third, and I go.”
She was given Chamomilla 30th, five tablets every three hours when not asleep, and asked to report in three days. She came in after school with the first smile I had seen on her face, and said: “Those pills worked as well on my head as the yellow ones did on my throat. I even kissed one of the little girls as she came to say `good-night.’ I want supply of both kinds of pills, to keep on hand, should either the throat or head trouble return. Now, if you could only give me something to prevent me from taking cold, I would be so grateful.”
As she stopped talking, the two remedies, “Kali carb, and Chamomilla” kept running through my mind, as the expression goes, “Which? both? or neither?” A moment’s thinking resulted in deciding to give the patient a good, long, fatherly talk, in which she was frankly told her condition, advised to let all medicines alone so long as she felt as well as she did then; but should there be a return of the menorrhagia to take the Kali carb., and should the mental condition return to take the Chamomilla, as she had taken them at first. She has been fairly comfortable for the past eleven years; has not lost her job; and the intervals between taking cold, flooding, and the attacks of irritability, etc., have grown longer. She has not been cured, but her condition has been greatly improved.
Let us now cite a third case to illustrate two points, first, the question of potency; second, the results sometimes obtained from prescribing on unreliable, unscientific authority and data.