Tuberculosis – The Medical Side of the Question (1904)

Following these lines the treatment of tubercular bone disease, periostitis, especially of the ribs or maxillae, Pott’s disease, etc., has yielded the most brilliant results and services of the surgeon have rarely been needed; the particular remedies most in use for such conditions have been Silicea and Aurum….

The treatment of the various phases of tuberculosis is dependent upon so many factors direct and contingent, that it embraces a large part of medical science. This paper will not therefore attempt a general resume of the subject but rather review some special considerations. The prognosis in a given case is so closely bound up in the anamnesis, the present state including the surrounding, the reactive power of the organism and the treatment that a just estimate of the outcome presents unusual difficulties. In this connection it may be well to point out the great importance which necessarily attaches to the relative chest capacity, for upon it depends the oxidising power of the whole organism with all its metabolic changes.

That cases do get well with the aid or in spite of treatment, or with no attention at all seems well established; but nature carries on her weeding out process most relentlessly when left to herself or when help is clumsily applied. Therefore it seems superfluous to say that all aid should take the most enlightened form; its specific application from a hygienic, climatic or dietetic point of view may well be left to the experts in this line while this paper will look the matter over from a therapeutic standpoint.

The curative power of remedies depends upon the very same elements that go to make up the prognosis, the chief one being vital reaction, closely followed by the nature and character of the anamnesis. This being true, the drugs curative in a given case must of necessity include in their pathogeneses as a primary action a similitude to the latest characteristic symptoms of the patient. Should it so happen that the secondary drug symptoms of the remedy administered also correspond to the earlier or dyscratic disease manifestations of the case in hand its curative power will extend along the entire line of disease effects and root them out fundamentally, often uncovering the basic dyscrasia upon the soil of which the tubercular process thrives. Most cases for various reasons do not present a picture clear enough for so sweeping a prescription. Then we are obliged to remove successive groups until the same end is attained, in act for reasons into which we will not enter here this is often the only safe procedure.

As will be seen from the above no one remedy can be looked upon as specific for any one disease. The search for specifics is for many reasons fundamentally fallacious; the principal one being that they are supposed to cure diseases, while in reality it is necessary to cure patients and not disease. It is no argument to say that certain medicines have cured such affections. The very fact that percentage is admitted into the discussion, vitiates all figures and puts the matter without the pale of a true scientific demonstration. This fact is very slowly but nevertheless surely finding its way among those that think and are not ruled by preconceived ideas.

The factors which play the chief diagnostic role hold a subordinate place in the choice of the curative remedy, although medicines whose pathogeneses point to them, may be used as a broad class from which those lacking the characteristics of the patient, may be dropped by a process of elimination until the symptom picture resembles that of the patient in a greater or less degree. Thus, Kyphosis, often but not necessarily due to tuberculosis, points toward Aconite, Asafoetida, Aurum, Bar c., Belladonna, Bryonia, Calcarea, Causticum, Cicuta, Clem., Colocynthis, Dulcamara, Hepar, Ipecac., Lachesis, Lycopodium, Mer, Met, Phosac., Plb., Pulsatilla, Rhusu., Ruta., Sabina, Sepia, Silicea, Staphysagria, Sul., and Thuja.

It is well known that sweats are apt to localize themselves over the affected organ, and in the pulmonary form they often show their presence quite early on the thorax. Of the above remedies the following have chest sweats; Belladonna, Calcarea, Hepar, Ipecac, Lycopodium, Mercurius, Phosphorus, Phos ac., Plb, Rhus., Sepia, Silicea This measurably reduces the number from which the choice may be made, always bearing in mind that the final resemblance between the drug effect and the disease picture of the patient, must present certain points of harmony called the “conditions” of the case, in which all kinds of external influences such as heat, cold, light, dampness etc., go to make up the differentiating shades in the final analysis.

We also take into consideration the subjective symptoms: resting as they do upon the comprehension and interpretation of the patient as well as of the physician, they require the nicest judgement and most careful discrimination to strip them of all superfluities and exuberances of expression on the one hand, as well as proper amplification’ and interpretation on the other. This is after all the crux of the art of prescribing and stamps the physician either as a rank empiric or a painstaking scientist.

C.M. Boger
Cyrus Maxwell Boger 5/ 13/ 1861 "“ 9/ 2/ 1935
Born in Western Pennsylvania, he graduated from the Philadelphia College of Pharmacy and subsequently Hahnemann Medical College of Philadelphia. He moved to Parkersburg, W. Va., in 1888, practicing there, but also consulting worldwide. He gave lectures at the Pulte Medical College in Cincinnati and taught philosophy, materia medica, and repertory at the American Foundation for Homoeopathy Postgraduate School. Boger brought BÅ“nninghausen's Characteristics and Repertory into the English Language in 1905. His publications include :
Boenninghausen's Characteristics and Repertory
Boenninghausen's Antipsorics
Boger's Diphtheria, (The Homoeopathic Therapeutics of)
A Synoptic Key of the Materia Medica, 1915
General Analysis with Card Index, 1931
Samarskite-A Proving
The Times Which Characterize the Appearance and Aggravation of the Symptoms and their Remedies