This disease is generally looked upon with terror, and well it may be, as it demands more than ordinary knowledge to conduct its victims to safety. To say that Homoeopathy is wanting at the bedside of these cases is far from true. It cures all cases where good vitality is present and where its remedies are wisely administered. To assume or admit that our lack of knowledge must be a common cause of so many failures is both true and untrue. It is true that more knowledge is required than the ordinary homoeopath possesses, or he would not be compelled to admit the several deaths in his confessions and reports. But to say that our knowledge and Homoeopathy in its present state of development could not be expected to do better is far from true. Our science is now developed to a high state of perfection, but individuals often fail to apply it in this disease with wisdom and judgment, and therefore lose many subjects.
The disease is not constantly with us, and when it comes it generally assumes a form unlike its previous appearances; and by the time the physician has carefully looked into the epidemic phases and remedial agents it has gone, leaving upon his hands severe and unfavorable terminations to cause regret and disappointment. The physician of studious habits and active practice, however, may so keep in touch with his principles and Materia Medica as to keep his death list remarkably small, but it must be observed that he, does not prescribe for every symptom that shows itself on the instant of its appearance. I will venture to say that any physician’s death list will be large if he hurries into bed chambers, looks at the tongue, takes the temperature? feels the pulse, looks into the throat, makes a culture, disinfects the house, washes the throat with antiseptics, etc. I will also venture to say that any physician’s death list will be remarkably small if he goes to the sick room and observes all the symptoms of the patient, all the surroundings of the house and room, sees all the obstructions, and knows the full purport of all things there, waits and watches the development of the sickness until its every feature has been manifested, if he knows when that time has come, and then carefully compares all the symptoms of this sickness with the symptoms of the Homoeopathic Materia Medica, and knows how to select the potency, how to administer it, and when not to give it.
How many of you can say all these things to yourself? How many of you do it in just this way. Do not most of you entertain the idea that you must make great haste to get medicine into that child’s stomach or it will get worse? Do not the most of you fear that the people will turn you off and get another physician if you do not do something at once? Do you know of any other class of work that would not be jeopardized and ruined by such haste as all of you do at the bedside in one of these serious sicknesses? If you are not guilty of this charge then you are not hurt, but it is so true of so large a number of our best men that no harm can come from hearing about it. To go to the bedside with fear and trembling is death to the sufferer. To go to the bedside with confidence born of knowing and from having trusted our means of cure so long, means life to the patrons of Homoeopathy. It is not that you are ignorant of your principles and your Materia Medica, but that these are not invoked at the time of greatest need. Through fear and haste you act and fail, whereas you should watch and wait and discover there is no hurry, and if the sickness has not yet shown what medicine this life stands in need of, wait even if you go and come repeatedly. Let it develop until its character is stamped upon the case so that no mistake can be made. A mistake in the first remedy nearly always means death, or at least it masks the case. It would be strange if you, who know so much about the art of healing, could make a first prescription of a remedy so far from similar that it did not act. You know if it is similar at all it will make changes in that symptom image, and if it is similar enough it will cure; therefore you need not hope that if your first prescription did not cure it was so dissimilar it was harmless. You must expect to cure, or begin the cure with the first prescription; then all is easy, as the changes now observed are such as bring joy to the hearts of the family and to the doctor. You must, therefore, never prescribe on the first flitting evidences of the sickness, but according to the true saying: “First be sure you are right and then go ahead.”
The first prescription, when correctly adjusted to the symptoms, will cause the membranes to fade out and all the characteristics of sickness with it.
The first prescription, when incorrectly chosen, will most likely change the symptoms, but the patient will go on from bad to worse and the next prescription must be a matter of guesswork, as the index has been spoiled, and hence the mortalities.
You know enough about your Materia Medica to do good work if you apply it properly. The Materia Medica is full and rich, and the Repertory points out the general and particular features. Guernsey’s cards are most useful aids. They are correctly compiled and within the reach of all. It is not more Materia Medica that is needed, but a correction in the faults at the bedside. The careful follower of all Hahnemann’s instructions in taking the case will avoid the errors I have mentioned, and save the necessity for a kind and generous counsel to say: “The treatment is just such as we would have given had we been here in the beginning!”
To find out which remedy to give is the important matter to be considered. The characteristics of a fatal case of this disease are as follows: 1st. No individualizing symptoms. 2nd. An ignorant physician, and this is the commonest cause of failure. The patient might as well be sick without symptoms as have plenty of symptoms and a doctor who knows not the meaning of symptoms.
A favorable prognosis may be made where there are plenty of symptoms to indicate a remedy and there is a doctor present who knows how to read these signs of nature. Always consider first that which is not commonly found in this disease and examine the remedies having such striking features.
The exudative inflammation in the throat, nose or larnyx, with the marked weakness and zymotic manifestations grouped as diphtheria, finds for remedies the following: Acid aceticum, Ail., Am-c., Apis, Arsenicum, Arum-t., Baptisia, Bromium, Bryonia, Cantharis, Caps., Carb-ac., Crot. horridus, Elaps., Hepar, Iodium, Kali-Bi., Kali-chl., Kali- mang., Kali-ph., Kreosotum, Lac-c., Lachesis, Lycopodium, Mercurius, Merc-c., Merc-cy., Merc-i- f., Merc-i-r., Acid Muriaticum, nitricum acidum, Phosphorus, Phyto., Rhus-t., Secale, Sul-ac., Sulphur, and no doubt many others.
It often happens that the nurses speak of the suffocation as soon as sleep comes, which is a symptom that often leads the neophyte to Lachesis, but this remedy may not cover the rest of the symptoms. The following remedies should be consulted, as they all have it as well as the general zymotic state, weakness and exudation: Am-c, Bryonia, Arum-t., Crot. horridus, Hepar., Kali-bi., lac-c., LACH., Lycopodium, Secale, Sulphur
The constant picking at the lips and nose has often pointed to Arum-t.
A type of case often observed where bleeding is an alarming sign; bleeding from nose, mouth and throat, when Bryonia, Crot-h, Lachesis, Phosphorus, Secale, Sulph-ac., would be the group to examine.
The odours from the mouth sometimes become important and lead to the study of remedies having putrid odours:
Apis, Arum-t., Baptisia, Bryonia, Carb-ac., Crot. horridus, Kali-bi., Kali-chl., Lachesis, Lycopodium, Mercurius, Merc-c., NIT-AC.,, PHYTO., Rhus-t., Secale, Sulphur
The well known mercury breath always leads to the examination of the various preparations of that remedy, such as MERC., Merc-c., Merc-cy., Merc-i-f, Merc-i-
The ropy, stringy mucus coming from the throat and air passages is often an important factor and the following remedies are to be examined: Apis, Arum-t., Carb-ac., KALI-Bi., Lachesis, Mercurius, Merc-c., Merc-i-f., PHYTO.
If white, Lachesis
If Yellow, KALI-BI., Lachesis
If the liquids which the patient attempts to swallow come out of the nose, consult ARUM-T. Cantharis, Carb-ac., KALI-BI., Kali-ma., Lac-c., Lachesis, Lycopodium, Mercurius, Merc-c., Merc-cy., Phyto., Sul-ac.
The gangrenous aspect of the throat is found in: Ail., Am-c., ARS., Arum-t., Baptisia, Carb-ac., Crot. horridus, Lachesis, Kali-ph., KREOS., Mur-ac., nitricum acidum, Phyto., Secale, Sul-ac., Sulphur
When ulceration is notable: ARS., Arum-t., Baptisia, Chlorum, Hepar, Iodium, Kali-bi., Lac-c., Mercurius, Merc-c., Merc-cy., Mur-ac., NIT-AC., Phyto. When swelling of the external throat and cervical glands is a marked feature: Arum-t., Lachesis, MERC., Merc-c., nitricum acidum, RHUS-T.
The following remedies have the disposition to constant swallowing observed in some cases: Arum-t., Hepar, Lac-c., Lachesis, Lycopodium, Mercurius, Merc-i-f.
From a lump in the throat: LACH.
The difficult swallowing in this disease is so common it can scarcely be taken as a guiding feature. Yet sometimes empty swallowing is very painful when solids can be swallowed easier and then the following should be inspected: Crot. horridus, LACH., Lac-c., Mercurius, Merc-i-f-, Merc-i-r.
Pain when not swallowing or pain ameliorated by swallowing is often important. CAPS., IGN., Lac-c., Lachesis
The marked distress in touching the throat is often a guiding feature and then Apis, Bromium, Bryonia, Lac-c., LACH., PHYTO., become a group of importance.
The pain is marked in some cases when anything warm is brought in contact with the throat, warm drinks, etc.: Apis, Lachesis, Lycopodium, PHYTO.
When cold things aggravate: Arsenicum, HEP., LYC., Sabad., Sulphur are to be considered.
The membrane has too many features to be examined in this short paper, and hence a repertory must be consulted. But when the exudation is predominantly on the right side: Apis, Ignatia, Lac-c., LYC., Merc-i-f., Phyto., Rhus-t.
When it extends to the left: Lac-c., LYC., Sulphur When predominantly on the left: Bromium, Crot-h-, Lac-c., LACH., Merc-i-r. Extending to the right: Lac-c., LACH.
When the exudate alternates sides, LAC-C, stands alone. When the exudate is predominantly in the nose: Am-c., Kali-bi., Lycopodium, Merc-c., Merc-cy.
When it extends to the nose: Kali-bi., Mercurius, Merc-c., Nit ac.
When the larnyx is the locality affected the state is far more serious and the following remedies must be consulted: Am-c., Apis., Arum-t., BROM., Carb-ac., Hepar, Iodium, Kali-bi., Kali-mang., Lac-c., Lachesis, Merc-cy., Merc-i-f., nitricum acidum, PHOS., Sanguinaria
When extending into the trachea: Iodium, KALI-BI., Phos,.