CLINICAL CASES


Farrington shares a wide range of clinical cases, allowing us to peak into his practice and experience how he saw patients and discovered homeopathic remedies for them….


A CASE OF PUERPERAL CONVULSIONS

MRS. — engaged me to attend her in confinement. She anticipated some trouble as she had not conceived before for fourteen years.

At the seventh month I was hurriedly summoned to her, the messenger informing me that she had a stroke of Apoplexy. I found her with suffused face, thick speech, heavy eye-lids, and considerable drowsiness. She evidently had had a convulsion and not Apoplexy. I gave her Gelsemium, and as she lived several miles from by office, left word to call in Dr. Chas. H. Smith, if she should be taken worse. I had it mind to leave a note for the doctor, suggesting Belladonna, if spasms should set in, as she was a stout lady, full-blooded and had previously complained of a throbbing headache over the right eye. But on second thought, I concluded to leave his mind unbiased.

My object in prescribing the Gelsemium was to endeavor to prevent spasms, rather than relieve them if they should occur. The immediate symptoms seemed to demand it. About midnight I was again called, and found my patient, in convulsions. Dr. Smith, who lives but two squares from the patient, had arrived before me and very properly gave belladonna 40m. The spasms began with flushing to the face, rolling up of the eye-balls, with biting of the tongue and violent jerkings of the whole body.

As the convulsive symptoms subsided, the face became purple and swollen, and she went off into deep, snoring sleep. The medicine was given every half-hour all night and until our visit the next fore-noon. We then found her in a continued deep sleep, from which aroused she would answer mechanically, but seemed not to recognize any one. The convulsions had ceased.

Three questions presented themselves to us. Shall we change the remedy, discontinue it, or repeat it? A change was absurd, for every symptom was still for Belladonna. Since her stupor was more profound, though the spasms had stopped, it was evident that either she was feeling the effects of her attacks or was going into a worse condition of coma. In either contingency, it would be best to suspend the remedy, so that the system might have opportunity to react in the one case, or that we might await developments, which would lead us to a new remedy if the case grew worse. She accordingly received Sac. Lac.

At my after-noon visit, I was met by the husband with the cheering words: “Doctor, she”s much better, that last medicine acted like a charm!” And better she certainly was. Her face was still swollen, but had lost much of its turgid appearance, she was conscious and had passed urine freely. Improvement continued for three days. Our immediate concern, now, was what was the condition of the foetus. No motions had been felt since the spasms. Camman’s stethoscope, however, enabled us to distinctly hear the foetal heart, which beat at the rate of about 140 per minute. Our next step was to examine into the condition of the mother’s kidneys. At my request Dr. Smith analyzed the urine and found it loaded with albumen. There was oedema of the face and slight swelling of both feet and ankles.

On the evening of the third day of relief, our patient became more restless, complained of feeling sore and tired, and of headache in the occipital region. Belladonna 40m was again resorted to. At about midnight she was seized with convulsions, which were not so intense as formerly, but lasted longer and caused a Paralysis of the right arm. Subsequent convulsive efforts were confined to the left side. No other remedy was indicated; even this Paralysis pointed to be Belladonna. So we pertinaciously continued, lengthening the intervals as the spasms diminished. Towards morning she became restless and though unconscious, complained and grunted, as if in labor.

The os externum was soft and dilatable, but the os internum was as firm as gristle. No attempt at artificial dilation was made, because the pains did not seem to threaten convulsions, and above all our trusty Belladonna was a better and safer dilator than clumsy instruments. A meddlesome doctor is an abomination. Daylight came and with it-not the baby, but an unwelcome cessation of all pains, while the patient sank into a stupid sort of sleep, from which she could not be aroused to consciousness. What was to be done?

I examined the symptoms carefully. Pulse regular, full; breathing snoring. but not stertorous; face red; pupils failed to react to light; right arm paralyzed; urine retained. Still Belladonna; but it was not needed so frequently as for the acute symptoms, so it was given for every two hours, and directions left to stop it entirely so soon as consciousness should return. The afternoon brought the desired relief; she recognized familiar faces, the pupils responded to light, the urine flowed freely and the patient became annoyingly aware of the condition of her right arm. In the evening she grew talkative, it was difficult to control her. Pains made her screw her face up; she said they were in her stomach and as they were followed by bleaching, I thought she was correct in her statement. But towards morning she began labor in earnest. Two or three vigorous pains were followed by the expulsion of a living, seven-month’s child.

The little fellow was as blue as indigo and cried with a faint voice, showing that its life had well-nigh been sacrificed by the terrible disturbances in the maternal circulation. It was wrapped in cotton batting, laid on its side, fed with milk in tea-spoons, hourly doses and treated with Laurocerasus 1m, as a corrective of its cyanotic condition.

The mother seemed to be in excellent spirits, talking so vociferously that threats were necessary to calm her. Her lame arm was still a mystery to her; for she had not been made acquainted with the character of the disease, she had passed through. She fancied she had had a chill with congestion to the head-an illusion I was very willing to leave undisputed.

The usual post-partum prescription of Arnica was omitted, because the labor had been too rapid and easy to need it and also because I desired the Belladonna impression to continue undisturbed.

The child died of cyanosis eight hours after birth.

The mother rallied steadily, regaining the use of her right arm in two days. Milk appeared in the usual time, but was unattended with any untoward symptoms. For several days the mother had occasional diarrhoeic stools composed of faeces and offensively-smelling bile; but as they seemed to relieve rather than aggravate the patient, it was deemed unnecessary if not meddlesome, to interfere.

The patient is now convalescing rapidly. She has regained the use of her arm and the symptoms of albuminuria are subsiding also.

AN AFFECTION OF THE SPINE – A CASE WITH COMMENTS

An intelligent patient came to me complaining of a singular heart trouble; several experts had pronounced him free from organic disease. There were various subjective symptoms, but the most marked was “a sensation after exercise, as if the heart were loose”. Physical examination showed no signs of hypertrophy or valvular lesion; but the heart muscle evidently lacked tonicity. When lying on the left side, the apex could be felt one inch to the right of a line drawn vertically from the axilla; and yet, the actual area was not over one inch and hence so far normal.

Most authorities state that the heart falls to the left when lying on that side, only sufficiently to bring the apex an inch or less to the left of a line through the nipple. But here was a variation of several inches, and yet no alteration in the size of the heart. Neither did there exist any disease of any neighboring viscus to displace the heart.

By turning on to the right side, the apex could be felt within or to the right of line through the nipple. I inferred a relaxed condition of the pericardium and of the connective tissues, producing great mobility, such as has been described in “movable kidney” (Flint’s Practice), and in other viscera. As confirmatory evidence, the patient related that often the muscles of the lumbar region and also the pectoral muscles would shake so on walking, that they would greatly inconvenience him.

If we trace the morbid tract still deeper, we shall find a weakened action of the motor nerve of the spine from central nervous exhaustion; and this in turn may arise from many sources. To determine the primal cause and so trace intelligently the disease from beginning to the present state, was the next step. I have often found that such a course of examination, unrolling as it were the panorama of the past, not only gives anamnesis of pathological importance, but, also exposes many long-forgotten characteristic symptoms of vital interest, in the selection of the curative remedy. Prescribing for the latest characteristics, is undoubtedly a positive key which unrolls the problem, until the cure is completed by eventually disclosing the whole picture.

This is the usual safest course, but if we can find a shorter way, we must follow it. And just here lies the advantage of Pathology, Physiology and the differential study of diseases. We know albumen in the urine points often to congestive kidney. We know excess of phosphates points to the nervous system. We know how Ague is indexed by a swollen spleen.

E. A. Farrington
E. A. Farrington (1847-1885) was born in Williamsburg, NY, on January 1, 1847. He began his study of medicine under the preceptorship of his brother, Harvey W. Farrington, MD. In 1866 he graduated from the Homoeopathic Medical College of Pennsylvania. In 1867 he entered the Hahnemann Medical College, graduating in 1868. He entered practice immediately after his graduation, establishing himself on Mount Vernon Street. Books by Ernest Farrington: Clinical Materia Medica, Comparative Materia Medica, Lesser Writings With Therapeutic Hints.